The Forum At Overland Park - Overland Park Nursing Home
General Information
UPDATEFederal Provider Number
175189
Provider Name
THE FORUM AT OVERLAND PARK
Provider Address
3501 W 95TH ST
OVERLAND PARK, KS 66206
OVERLAND PARK, KS 66206
Provider Phone Number
(913) 648-4980
Provider SSA County
450
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
46
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
FIVE STAR OVERLAND PARK LLC
Date First Approved to Provide Medicare and Medicaid services
1989-08-10
Continuing Care Retirement Community
Y
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
3
Health Inspection Rating Footnote
QM Rating
3
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
3.99130
Reported LPN Staffing Hours per Resident per Day
0.80870
Reported RN Staffing Hours per Resident per Day
1.46087
Reported Licensed Staffing Hours per Resident per Day
2.26957
Reported Total Nurse Staffing Hours per Resident per Day
6.26087
Reported Physical Therapist Staffing Hours per Resident Per Day
0.36196
Expected CNA Staffing Hours per Resident per Day
2.59782
Expected LPN Staffing Hours per Resident per Day
0.68890
Expected RN Staffing Hours per Resident per Day
1.13844
Expected Total Nurse Staffing Hours per Resident per Day
4.42516
Adjusted CNA Staffing Hours per Resident per Day
3.76987
Adjusted LPN Staffing Hours per Resident per Day
0.97434
Adjusted RN Staffing Hours per Resident per Day
0.95882
Adjusted Total Nurse Staffing Hours per Resident per Day
5.70306
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-11-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-07-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-04-10
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
56.66700
Number of Facility Reported Incidents
2
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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