Solomon Valley Manor - Stockton Nursing Home

General Information

UPDATE
Federal Provider Number
17E637
Provider Name
SOLOMON VALLEY MANOR
Provider Address
315 S ASH ST
STOCKTON, KS 67669
Provider Phone Number
(785) 425-6754
Provider SSA County
810
Provider County Name
Rooks
Provider Website
Provider Description
Ownership Type
Government - City
Number of Certified Beds
33
Number of Residents in Certified Beds
30
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2012-01-20
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
3
Overall Rating Footnote
Health Inspection Rating
4
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
2.35500
Reported LPN Staffing Hours per Resident per Day
0.65000
Reported RN Staffing Hours per Resident per Day
0.51333
Reported Licensed Staffing Hours per Resident per Day
1.16333
Reported Total Nurse Staffing Hours per Resident per Day
3.51833
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.22667
Expected LPN Staffing Hours per Resident per Day
0.54557
Expected RN Staffing Hours per Resident per Day
0.82741
Expected Total Nurse Staffing Hours per Resident per Day
3.59966
Adjusted CNA Staffing Hours per Resident per Day
2.59512
Adjusted LPN Staffing Hours per Resident per Day
0.98887
Adjusted RN Staffing Hours per Resident per Day
0.46357
Adjusted Total Nurse Staffing Hours per Resident per Day
3.93983
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-09-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-06-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
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
2012-05-03
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
44.00000
Number of Facility Reported Incidents
1
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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