Salem Home - Hillsboro Nursing Home
General Information
UPDATEFederal Provider Number
175484
Provider Name
SALEM HOME
Provider Address
704 S ASH
HILLSBORO, KS 67063
HILLSBORO, KS 67063
Provider Phone Number
(620) 947-1429
Provider SSA County
570
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SALEM HOSPITAL, INC.
Date First Approved to Provide Medicare and Medicaid services
2005-04-05
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.67436
Reported LPN Staffing Hours per Resident per Day
0.43205
Reported RN Staffing Hours per Resident per Day
0.66282
Reported Licensed Staffing Hours per Resident per Day
1.09487
Reported Total Nurse Staffing Hours per Resident per Day
3.76923
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.14923
Expected LPN Staffing Hours per Resident per Day
0.53997
Expected RN Staffing Hours per Resident per Day
0.78591
Expected Total Nurse Staffing Hours per Resident per Day
3.47511
Adjusted CNA Staffing Hours per Resident per Day
3.05323
Adjusted LPN Staffing Hours per Resident per Day
0.66412
Adjusted RN Staffing Hours per Resident per Day
0.63017
Adjusted Total Nurse Staffing Hours per Resident per Day
4.37206
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-08-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-05-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
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
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