The Shepherd's Center - Cimarron Nursing Home
General Information
UPDATEFederal Provider Number
17E488
Provider Name
THE SHEPHERD'S CENTER
Provider Address
706 N MAIN PO BOX 249
CIMARRON, KS 67835
CIMARRON, KS 67835
Provider Phone Number
(620) 855-3498
Provider SSA County
340
Provider County Name
Gray
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
24
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
1978-05-03
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
2.52917
Reported LPN Staffing Hours per Resident per Day
0.44167
Reported RN Staffing Hours per Resident per Day
0.97292
Reported Licensed Staffing Hours per Resident per Day
1.41458
Reported Total Nurse Staffing Hours per Resident per Day
3.94376
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.11196
Expected LPN Staffing Hours per Resident per Day
0.57681
Expected RN Staffing Hours per Resident per Day
0.78109
Expected Total Nurse Staffing Hours per Resident per Day
3.46986
Adjusted CNA Staffing Hours per Resident per Day
2.93842
Adjusted LPN Staffing Hours per Resident per Day
0.63554
Adjusted RN Staffing Hours per Resident per Day
0.93071
Adjusted Total Nurse Staffing Hours per Resident per Day
4.58143
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-12-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
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
36
Cycle 3 Standard Health Survey Date
2012-05-29
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
49.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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