Salem Memorial District Hospital - Salem Nursing Home
General Information
UPDATEFederal Provider Number
26A381
Provider Name
SALEM MEMORIAL DISTRICT HOSPITAL
Provider Address
PO BOX 774, 35629 HIGHWAY 72
SALEM, MO 65560
SALEM, MO 65560
Provider Phone Number
5737296626
Provider SSA County
320
Provider County Name
Dent
Ownership Type
Government - Hospital district
Number of Certified Beds
18
Number of Residents in Certified Beds
18
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1992-06-25
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
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.66667
Reported LPN Staffing Hours per Resident per Day
1.00000
Reported RN Staffing Hours per Resident per Day
0.77778
Reported Licensed Staffing Hours per Resident per Day
1.77778
Reported Total Nurse Staffing Hours per Resident per Day
4.44445
Reported Physical Therapist Staffing Hours per Resident Per Day
0.31667
Expected CNA Staffing Hours per Resident per Day
2.34010
Expected LPN Staffing Hours per Resident per Day
0.55755
Expected RN Staffing Hours per Resident per Day
0.77961
Expected Total Nurse Staffing Hours per Resident per Day
3.67725
Adjusted CNA Staffing Hours per Resident per Day
2.79613
Adjusted LPN Staffing Hours per Resident per Day
1.48866
Adjusted RN Staffing Hours per Resident per Day
0.74545
Adjusted Total Nurse Staffing Hours per Resident per Day
4.87188
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-10-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
23
Cycle 2 Number of Standard Health Deficiencies
23
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
196
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
98
Cycle 2 Total Health Score
98
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-11-20
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
22
Cycle 3 Total Health Score
66
Total Weighted Health Survey Score
123.00000
Number of Facility Reported Incidents
0
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
Nursiong Homes Nearby
Seville Care Center
35625 Highway 72, Po Box 746 |
SALEM MO 65560 | 0.1 mile away
Salem Care Center
1203 N Jackson, Po Box 29 |
SALEM MO 65560 | 1.8 miles away
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