Ottawa Retirement Village - Ottawa Nursing Home
General Information
UPDATEFederal Provider Number
175332
Provider Name
OTTAWA RETIREMENT VILLAGE
Provider Address
1100 W 15TH ST
OTTAWA, KS 66067
OTTAWA, KS 66067
Provider Phone Number
(785) 242-5399
Provider SSA County
290
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
OTTAWA RETIREMENT VILLAGE, INC.
Date First Approved to Provide Medicare and Medicaid services
1995-01-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.53769
Reported LPN Staffing Hours per Resident per Day
0.71154
Reported RN Staffing Hours per Resident per Day
0.62231
Reported Licensed Staffing Hours per Resident per Day
1.33385
Reported Total Nurse Staffing Hours per Resident per Day
3.87154
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.36923
Expected LPN Staffing Hours per Resident per Day
0.66480
Expected RN Staffing Hours per Resident per Day
1.17857
Expected Total Nurse Staffing Hours per Resident per Day
4.21260
Adjusted CNA Staffing Hours per Resident per Day
2.62816
Adjusted LPN Staffing Hours per Resident per Day
0.88835
Adjusted RN Staffing Hours per Resident per Day
0.39454
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70455
Cycle 1 Total Number of Health Deficiencies
33
Cycle 1 Number of Standard Health Deficiencies
29
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
248
Cycle 1 Standard Survey Health Date
2014-11-10
Cycle 1 Number of Health Revisits
3
Cycle 1 Health Revisit Score
174
Cycle 1 Total Health Score
422
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-08-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-04-16
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
253.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
4063
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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