Windsor Place Llc - Coffeyville Nursing Home
General Information
UPDATEFederal Provider Number
175290
Provider Name
WINDSOR PLACE LLC
Provider Address
2921 W 1ST ST
COFFEYVILLE, KS 67337
COFFEYVILLE, KS 67337
Provider Phone Number
(620) 251-5190
Provider SSA County
620
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
163
Number of Residents in Certified Beds
122
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEALTH MANAGEMENT OF KANSAS INC
Date First Approved to Provide Medicare and Medicaid services
1994-05-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
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
3.38893
Reported LPN Staffing Hours per Resident per Day
0.64549
Reported RN Staffing Hours per Resident per Day
0.91230
Reported Licensed Staffing Hours per Resident per Day
1.55779
Reported Total Nurse Staffing Hours per Resident per Day
4.94672
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04672
Expected CNA Staffing Hours per Resident per Day
2.54694
Expected LPN Staffing Hours per Resident per Day
0.61326
Expected RN Staffing Hours per Resident per Day
0.93328
Expected Total Nurse Staffing Hours per Resident per Day
4.09349
Adjusted CNA Staffing Hours per Resident per Day
3.26486
Adjusted LPN Staffing Hours per Resident per Day
0.87362
Adjusted RN Staffing Hours per Resident per Day
0.73040
Adjusted Total Nurse Staffing Hours per Resident per Day
4.87109
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
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
44
Cycle 2 Standard Health Survey Date
2013-10-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-06-18
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
59.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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