Wellsville Manor - Wellsville Nursing Home
General Information
UPDATEFederal Provider Number
175250
Provider Name
WELLSVILLE MANOR
Provider Address
304 W 7TH ST
WELLSVILLE, KS 66092
WELLSVILLE, KS 66092
Provider Phone Number
(785) 883-4101
Provider SSA County
290
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
51
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MYSTERE LIVING & HEALTHCARE, INC.
Date First Approved to Provide Medicare and Medicaid services
1993-04-15
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.80172
Reported LPN Staffing Hours per Resident per Day
0.28793
Reported RN Staffing Hours per Resident per Day
0.50086
Reported Licensed Staffing Hours per Resident per Day
0.78879
Reported Total Nurse Staffing Hours per Resident per Day
3.59051
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00603
Expected CNA Staffing Hours per Resident per Day
2.16498
Expected LPN Staffing Hours per Resident per Day
0.57117
Expected RN Staffing Hours per Resident per Day
0.93559
Expected Total Nurse Staffing Hours per Resident per Day
3.67173
Adjusted CNA Staffing Hours per Resident per Day
3.17536
Adjusted LPN Staffing Hours per Resident per Day
0.41841
Adjusted RN Staffing Hours per Resident per Day
0.40001
Adjusted Total Nurse Staffing Hours per Resident per Day
3.94173
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
157
Cycle 1 Standard Survey Health Date
2014-08-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
157
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-05-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2012-01-12
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
96.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
3965
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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