Salt River Community Care - Shelbina Nursing Home
General Information
UPDATEFederal Provider Number
265694
Provider Name
SALT RIVER COMMUNITY CARE
Provider Address
142 SHELBY PLAZA ROAD, PO BOX 529
SHELBINA, MO 63468
SHELBINA, MO 63468
Provider Phone Number
(573) 588-4175
Provider SSA County
984
Provider County Name
Shelby
Provider Website
Provider Description
Ownership Type
Government - City/county
Number of Certified Beds
120
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SALT RIVER NURSING HOME DISTRICT
Date First Approved to Provide Medicare and Medicaid services
1998-07-01
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
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
1
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
3.19351
Reported LPN Staffing Hours per Resident per Day
0.88182
Reported RN Staffing Hours per Resident per Day
0.67987
Reported Licensed Staffing Hours per Resident per Day
1.56169
Reported Total Nurse Staffing Hours per Resident per Day
4.75520
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07403
Expected CNA Staffing Hours per Resident per Day
2.26034
Expected LPN Staffing Hours per Resident per Day
0.60098
Expected RN Staffing Hours per Resident per Day
0.84677
Expected Total Nurse Staffing Hours per Resident per Day
3.70809
Adjusted CNA Staffing Hours per Resident per Day
3.46670
Adjusted LPN Staffing Hours per Resident per Day
1.21787
Adjusted RN Staffing Hours per Resident per Day
0.59992
Adjusted Total Nurse Staffing Hours per Resident per Day
5.16917
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-10
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-10-15
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
8.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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