Hickory Manor
Hickory Manor Information
| Facility Name | Hickory Manor |
| Location | 209 Hickory Street, Licking, MO 65542 |
| County (SSA Code) | Texas (989) |
| Phone Number | 573-674-2111 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 60 |
| Average Number of Residents | 31.9 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Both |
| Provider Business Name | LICKING NO 1 LLC |
| Ownership Type | For profit - Limited Liability company |
| Date First Approved | 1996-04-03 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.30559 |
| Reported LPN Staffing Hours per Resident per Day | 0.8438 |
| Reported RN Staffing - Hours per Resident per Day | 0.48038 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.32418 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.62978 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.01098 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 1.98696 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.65684 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.30797 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 2.95176 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.92051 |
| Total Weighted Health Survey Score for three cycles | 35.333 |
| Rating cycle 1 Standard Survey Health Date | 2019-06-20 |
| Rating cycle 1 - Health Deficiency Score | 9 |
| Rating cycle 1 - Total Health Inspection Score | 28 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-04-26 |
| Rating cycle 2 - Health Deficiency Score | 28 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-05-25 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 1 |
| Number of Substantiated Complaints | 1 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |