Wallace County Community Care Center Inc - Sharon Spgs Nursing Home

General Information

UPDATE
Federal Provider Number
175524
Provider Name
WALLACE COUNTY COMMUNITY CARE CENTER INC
Provider Address
608 N KENNEDY
SHARON SPGS, KS 67758
Provider Phone Number
7858524244
Provider SSA County
981
Provider County Name
Wallace
Ownership Type
Non profit - Corporation
Number of Certified Beds
24
Number of Residents in Certified Beds
22
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WALLACE COUNTY COMMUNITY CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
2012-05-03
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
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
3.53636
Reported LPN Staffing Hours per Resident per Day
0.32727
Reported RN Staffing Hours per Resident per Day
1.20455
Reported Licensed Staffing Hours per Resident per Day
1.53182
Reported Total Nurse Staffing Hours per Resident per Day
5.06818
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02045
Expected CNA Staffing Hours per Resident per Day
2.31667
Expected LPN Staffing Hours per Resident per Day
0.62955
Expected RN Staffing Hours per Resident per Day
0.91751
Expected Total Nurse Staffing Hours per Resident per Day
3.86373
Adjusted CNA Staffing Hours per Resident per Day
3.74553
Adjusted LPN Staffing Hours per Resident per Day
0.43148
Adjusted RN Staffing Hours per Resident per Day
0.98096
Adjusted Total Nurse Staffing Hours per Resident per Day
5.28746
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-07-28
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
44
Cycle 1 Total Health Score
132
Cycle 2 Total Number of Health Deficiencies
25
Cycle 2 Number of Standard Health Deficiencies
25
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
172
Cycle 2 Standard Health Survey Date
2013-04-10
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
124
Cycle 3 Standard Health Survey Date
2011-12-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
124
Total Weighted Health Survey Score
144.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
2
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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