Pine Village
Pine Village Information
| Facility Name | Pine Village |
| Location | 86 Twenty-second Avenue, Moundridge, KS 67107 |
| County (SSA Code) | Mcpherson (560) |
| Phone Number | 620-345-2901 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 74 |
| Average Number of Residents | 64.5 |
| CCRC Facility? | Yes |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | Yes |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | MEMORIAL HOME, INC. |
| Ownership Type | Non profit - Corporation |
| Date First Approved | 1997-04-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 3.55049 |
| Reported LPN Staffing Hours per Resident per Day | 0.93818 |
| Reported RN Staffing - Hours per Resident per Day | 0.49978 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.43796 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.98845 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.00798 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 1.90212 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.63872 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.29046 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 2.8313 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 5.61723 |
| Total Weighted Health Survey Score for three cycles | 23.333 |
| Rating cycle 1 Standard Survey Health Date | 2020-03-02 |
| Rating cycle 1 - Health Deficiency Score | 2 |
| Date of Rating cycle 2 Standard Health Survey Date | 2019-02-25 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-12-05 |
| Rating cycle 3 - Health Deficiency Score | 56 |
| Rating cycle 3 - Total Health Inspection Score | 56 |
| Number of Facility-Reported Incidents | 1 |
| Number of Substantiated Complaints | 0 |
| Number of Substantiated Complaints | 0 |
| Number of Fines | 1 |
| Total Amount of Fines (in Dollars) | 18370 |
| Total Number of Penalties | 1 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |