Sunset Home - Maysville Nursing Home
General Information
UPDATEFederal Provider Number
265745
Provider Name
SUNSET HOME
Provider Address
1201 S. POLK
MAYSVILLE, MO 64469
MAYSVILLE, MO 64469
Provider Phone Number
8164492158
Provider SSA County
310
Provider County Name
De Kalb
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
N & R OF MAYSVILLE, LLC
Date First Approved to Provide Medicare and Medicaid services
2002-12-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
1.72870
Reported LPN Staffing Hours per Resident per Day
0.23889
Reported RN Staffing Hours per Resident per Day
0.71019
Reported Licensed Staffing Hours per Resident per Day
0.94907
Reported Total Nurse Staffing Hours per Resident per Day
2.67778
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01204
Expected CNA Staffing Hours per Resident per Day
1.74903
Expected LPN Staffing Hours per Resident per Day
0.54226
Expected RN Staffing Hours per Resident per Day
0.74871
Expected Total Nurse Staffing Hours per Resident per Day
3.04000
Adjusted CNA Staffing Hours per Resident per Day
2.42518
Adjusted LPN Staffing Hours per Resident per Day
0.36565
Adjusted RN Staffing Hours per Resident per Day
0.70876
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55062
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
116
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
116
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
131
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
48
Cycle 3 Total Health Score
144
Total Weighted Health Survey Score
125.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
16
Number of Fines
1
Total Amount of Fines in Dollars
5363
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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