Park Villa - Clyde Nursing Home
General Information
UPDATEFederal Provider Number
175492
Provider Name
PARK VILLA
Provider Address
114 S HIGH ST
CLYDE, KS 66938
CLYDE, KS 66938
Provider Phone Number
7854462818
Provider SSA County
140
Provider County Name
Cloud
Ownership Type
Non profit - Corporation
Number of Certified Beds
36
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLYDE DEVELOPMENT INC
Date First Approved to Provide Medicare and Medicaid services
2007-09-28
Continuing Care Retirement Community
N
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
2.31029
Reported LPN Staffing Hours per Resident per Day
1.01029
Reported RN Staffing Hours per Resident per Day
0.54265
Reported Licensed Staffing Hours per Resident per Day
1.55294
Reported Total Nurse Staffing Hours per Resident per Day
3.86323
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01324
Expected CNA Staffing Hours per Resident per Day
2.62487
Expected LPN Staffing Hours per Resident per Day
0.56436
Expected RN Staffing Hours per Resident per Day
0.79927
Expected Total Nurse Staffing Hours per Resident per Day
3.98849
Adjusted CNA Staffing Hours per Resident per Day
2.15964
Adjusted LPN Staffing Hours per Resident per Day
1.48583
Adjusted RN Staffing Hours per Resident per Day
0.50730
Adjusted Total Nurse Staffing Hours per Resident per Day
3.90430
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-12-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
18
Cycle 2 Number of Complaint Health Deficiencies
15
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-09-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
56
Cycle 3 Standard Health Survey Date
2012-06-21
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
82.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Sunset Home Inc
620 Second Ave |
CONCORDIA KS 66901 | 14.2 miles away
Mount Joseph Senior Village Llc
1110 W 11th |
CONCORDIA KS 66901 | 14.5 miles away
The Nicol Home
303 E Buffalo St |
GLASCO KS 67445 | 27.9 miles away
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