Overall Rating
Address
20911 West 153rd Street
Olathe, KS 66061
Contact
9133972900
Certification Date
2006-10-20
CMS Certification Number
175491
Ownership Type
Non profit - Other
Number of Certified Beds
34
Average Number of Residents per Day
28.4
Provider Type
Medicare
Legal Business Name
CEDAR LAKE VILLAGE INC
Affiliated Entity Name
EVANGELICAL GOOD SAMARITAN SOCIETY
Affiliated Entity ID
584
Health Inspection Rating
2
Quality Measure Rating
3
Staffing Rating
5
Reported Nurse Aide Staffing Hours per Resident per Day
2.26276
Reported LPN Staffing Hours per Resident per Day
1.15344
Reported RN Staffing Hours per Resident per Day
1.56394
Reported Total Nurse Staffing Hours per Resident per Day
4.98014
Total Number of Nurse Staff Hours per Resident per Day on the Weekend
4.38072
Registered Nurse Hours per Resident per Day on the Weekend
1.14580
Reported Physical Therapist Staffing Hours per Resident Per Day
0.59237
Long-Stay Quality Measure Rating
Short-Stay Quality Measure Rating
3
Total Weighted Health Survey Score
62.000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
Number of Citations from Infection Control Inspections
Standard Health Survey Date
2023-08-31
Total Number of Health Deficiencies
7
Number of Standard Health Deficiencies
7
Number of Complaint Health Deficiencies
7
Health Deficiency Score
68
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
68
Standard Health Survey Date
2022-01-27
Total Number of Health Deficiencies
11
Number of Standard Health Deficiencies
10
Number of Complaint Health Deficiencies
1
Health Deficiency Score
56
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
56
Standard Health Survey Date
2020-01-13
Total Number of Health Deficiencies
10
Number of Standard Health Deficiencies
10
Number of Complaint Health Deficiencies
0
Health Deficiency Score
56
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
56
Number of Fines
1
Total Amount of Fines in Dollars
3250.00
Number of Payment Denials
1
Total Number of Penalties
2