Stonecrest Healthcare - Viburnum Nursing Home
General Information
UPDATEFederal Provider Number
265582
Provider Name
STONECREST HEALTHCARE
Provider Address
2 HIGHWAY Y, PO BOX 707
VIBURNUM, MO 65566
VIBURNUM, MO 65566
Provider Phone Number
(573) 244-3171
Provider SSA County
460
Provider County Name
Iron
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MMA HEALTHCARE OF VIBURNUM INC
Date First Approved to Provide Medicare and Medicaid services
1994-07-05
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
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.06491
Reported LPN Staffing Hours per Resident per Day
0.38070
Reported RN Staffing Hours per Resident per Day
0.24035
Reported Licensed Staffing Hours per Resident per Day
0.62105
Reported Total Nurse Staffing Hours per Resident per Day
2.68596
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00965
Expected CNA Staffing Hours per Resident per Day
1.66987
Expected LPN Staffing Hours per Resident per Day
0.51344
Expected RN Staffing Hours per Resident per Day
0.61485
Expected Total Nurse Staffing Hours per Resident per Day
2.79816
Adjusted CNA Staffing Hours per Resident per Day
3.03417
Adjusted LPN Staffing Hours per Resident per Day
0.61543
Adjusted RN Staffing Hours per Resident per Day
0.29209
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86927
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-11-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-12-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
61.33300
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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