Victoria Falls - Andover Nursing Home
General Information
UPDATEFederal Provider Number
175520
Provider Name
VICTORIA FALLS
Provider Address
224 E CENTRAL
ANDOVER, KS 67002
ANDOVER, KS 67002
Provider Phone Number
(316) 733-0654
Provider SSA County
70
Provider County Name
Butler
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
76
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ANDOVER SENIOR CARE, LLC
Date First Approved to Provide Medicare and Medicaid services
2011-03-25
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.40368
Reported LPN Staffing Hours per Resident per Day
1.02426
Reported RN Staffing Hours per Resident per Day
0.54706
Reported Licensed Staffing Hours per Resident per Day
1.57132
Reported Total Nurse Staffing Hours per Resident per Day
4.97500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08382
Expected CNA Staffing Hours per Resident per Day
2.18393
Expected LPN Staffing Hours per Resident per Day
0.60703
Expected RN Staffing Hours per Resident per Day
0.97764
Expected Total Nurse Staffing Hours per Resident per Day
3.76859
Adjusted CNA Staffing Hours per Resident per Day
3.82413
Adjusted LPN Staffing Hours per Resident per Day
1.40049
Adjusted RN Staffing Hours per Resident per Day
0.41811
Adjusted Total Nurse Staffing Hours per Resident per Day
5.32128
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
14
Cycle 1 Health Deficiency Score
124
Cycle 1 Standard Survey Health Date
2015-02-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
124
Cycle 2 Total Number of Health Deficiencies
21
Cycle 2 Number of Standard Health Deficiencies
19
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
456
Cycle 2 Standard Health Survey Date
2014-04-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
456
Cycle 3 Total Number of Health Deficiencies
20
Cycle 3 Number of Standard Health Deficiencies
20
Cycle 3 Number of Complaint Health Deficiencies
20
Cycle 3 Health Deficiency Score
164
Cycle 3 Standard Health Survey Date
2013-04-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
164
Total Weighted Health Survey Score
241.33300
Number of Facility Reported Incidents
9
Number of Substantiated Complaints
40
Number of Fines
1
Total Amount of Fines in Dollars
126620
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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