Wilshire At Lakewood - Lees Summit Nursing Home
General Information
UPDATEFederal Provider Number
265700
Provider Name
WILSHIRE AT LAKEWOOD
Provider Address
600 N E MEADOWVIEW DRIVE
LEES SUMMIT, MO 64064
LEES SUMMIT, MO 64064
Provider Phone Number
(816) 554-9866
Provider SSA County
470
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
170
Number of Residents in Certified Beds
142
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LAKEWOOD CARE CENTER OF LEE'S SUMMIT, L.C.
Date First Approved to Provide Medicare and Medicaid services
1999-06-18
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
4
Health Inspection Rating Footnote
QM Rating
2
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
2.48873
Reported LPN Staffing Hours per Resident per Day
0.84542
Reported RN Staffing Hours per Resident per Day
0.60106
Reported Licensed Staffing Hours per Resident per Day
1.44648
Reported Total Nurse Staffing Hours per Resident per Day
3.93521
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00599
Expected CNA Staffing Hours per Resident per Day
2.16409
Expected LPN Staffing Hours per Resident per Day
0.61022
Expected RN Staffing Hours per Resident per Day
1.03285
Expected Total Nurse Staffing Hours per Resident per Day
3.80717
Adjusted CNA Staffing Hours per Resident per Day
2.82178
Adjusted LPN Staffing Hours per Resident per Day
1.14991
Adjusted RN Staffing Hours per Resident per Day
0.43483
Adjusted Total Nurse Staffing Hours per Resident per Day
4.16646
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
20
Cycle 1 Standard Survey Health Date
2015-04-06
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-06-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-04-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
26.00000
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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