U-city Forest Manor - Saint Louis Nursing Home
General Information
UPDATEFederal Provider Number
265736
Provider Name
U-CITY FOREST MANOR
Provider Address
1301 PARTRIDGE AVENUE
SAINT LOUIS, MO 63130
SAINT LOUIS, MO 63130
Provider Phone Number
(314) 862-5556
Provider SSA County
940
Provider County Name
St. Louis
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
120
Number of Residents in Certified Beds
90
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
U-CITY FOREST MANOR, LLC
Date First Approved to Provide Medicare and Medicaid services
2002-05-21
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
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.92111
Reported LPN Staffing Hours per Resident per Day
0.57944
Reported RN Staffing Hours per Resident per Day
0.22167
Reported Licensed Staffing Hours per Resident per Day
0.80111
Reported Total Nurse Staffing Hours per Resident per Day
3.72222
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12722
Expected CNA Staffing Hours per Resident per Day
2.10136
Expected LPN Staffing Hours per Resident per Day
0.54939
Expected RN Staffing Hours per Resident per Day
0.87884
Expected Total Nurse Staffing Hours per Resident per Day
3.52959
Adjusted CNA Staffing Hours per Resident per Day
3.41090
Adjusted LPN Staffing Hours per Resident per Day
0.87539
Adjusted RN Staffing Hours per Resident per Day
0.18847
Adjusted Total Nurse Staffing Hours per Resident per Day
4.25089
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
136
Cycle 1 Standard Survey Health Date
2014-09-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
136
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-08-14
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
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-08-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
96.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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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