Missouri Nursing Homes >> O'fallon Nursing Homes >> Villa Theresa Haven

Villa Theresa Haven - O'fallon Nursing Home

General Information

UPDATE
Federal Provider Number
265839
Provider Name
VILLA THERESA HAVEN
Provider Address
206 NORTH MAIN STREET
O'FALLON, MO 63366
Provider Phone Number
(636) 240-5754
Provider SSA County
910
Provider County Name
Saint Charles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SMI SNF TENANT LLC
Date First Approved to Provide Medicare and Medicaid services
2011-03-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.25600
Reported LPN Staffing Hours per Resident per Day
0.89000
Reported RN Staffing Hours per Resident per Day
0.37100
Reported Licensed Staffing Hours per Resident per Day
1.26100
Reported Total Nurse Staffing Hours per Resident per Day
3.51700
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04000
Expected CNA Staffing Hours per Resident per Day
2.20229
Expected LPN Staffing Hours per Resident per Day
0.61547
Expected RN Staffing Hours per Resident per Day
0.90182
Expected Total Nurse Staffing Hours per Resident per Day
3.71958
Adjusted CNA Staffing Hours per Resident per Day
2.51354
Adjusted LPN Staffing Hours per Resident per Day
1.20021
Adjusted RN Staffing Hours per Resident per Day
0.30739
Adjusted Total Nurse Staffing Hours per Resident per Day
3.81137
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
48
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-11-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
30.66700
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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