Trinity Manor - Dodge City Nursing Home
General Information
UPDATEFederal Provider Number
175377
Provider Name
TRINITY MANOR
Provider Address
510 W FRONTVIEW ST
DODGE CITY, KS 67801
DODGE CITY, KS 67801
Provider Phone Number
(620) 227-8551
Provider SSA County
280
Provider County Name
Ford
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRINITY MANOR OPCO LLC
Date First Approved to Provide Medicare and Medicaid services
1996-10-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.72143
Reported LPN Staffing Hours per Resident per Day
0.37411
Reported RN Staffing Hours per Resident per Day
0.85357
Reported Licensed Staffing Hours per Resident per Day
1.22768
Reported Total Nurse Staffing Hours per Resident per Day
3.94911
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14196
Expected CNA Staffing Hours per Resident per Day
2.42541
Expected LPN Staffing Hours per Resident per Day
0.62549
Expected RN Staffing Hours per Resident per Day
1.03159
Expected Total Nurse Staffing Hours per Resident per Day
4.08249
Adjusted CNA Staffing Hours per Resident per Day
2.75318
Adjusted LPN Staffing Hours per Resident per Day
0.49643
Adjusted RN Staffing Hours per Resident per Day
0.61826
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89921
Cycle 1 Total Number of Health Deficiencies
30
Cycle 1 Number of Standard Health Deficiencies
30
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
267
Cycle 1 Standard Survey Health Date
2014-04-09
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
134
Cycle 1 Total Health Score
401
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-04-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
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
68
Cycle 3 Standard Health Survey Date
2011-12-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
227.83300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
Number of Fines
1
Total Amount of Fines in Dollars
25558
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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