Provider Name: SALEM MEMORIAL DISTRICT HOSPITAL
Address: 35629 HIGHWAY 72, SALEM, MO 65560
Phone: (573) 729-6626
County: Dent (320)
Ownership Type: Government - Hospital district
Certified Beds: 18
Average Residents Per Day: 16.5 ()
Provider Type: Medicaid, Resides in Hospital: No
Legal Business Name: Legal Business Name Not Available
First Approved Date: June 25, 1992
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 4 ()
Health Inspection Rating: 5 ()
QM Rating: 4 ()
Long Stay QM Rating: 4 ()
Short Stay QM Rating: (2)
Staffing Rating: 1 (12)
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.62579, LPN Staff Hours Per Day: 0.7959, RN Staff Hours Per Day: 1.0462, Licensed Staff Hours Per Day: 1.8422
Total Nurse Staff Hours Per Day, per resident: 4.46802
Weekend Nurse Staff Hours: 3.98809, Weekend RN Staff Hours: 0.7286
PT Staff Hours Per Day, per resident: 0.0000
Nurse Staff Turnover: , Nurse Turnover Note: 6
RN Turnover: , RN Turnover Note: 6
Admin Left Number: , Admin Turnover Note: 6
Case Mix Nurse Aide Hours Per Day, per resident: 2.0418, Case Mix LPN Hours Per Day: 0.6278, Case Mix RN Hours Per Day: 0.3041
Adjusted Nurse Aide Hours Per Day, per resident: 2.61992, Adjusted LPN Hours Per Day: 0.9356, Adjusted RN Hours Per Day: 1.2963
Total Adjusted Nurse Hours Per Day, per resident: 4.73589
Adjusted Weekend Nurse Hours Per Day, per resident: 4.22719
Health Survey Dates and Scores: Cycle 1: 2023-08-22 (Score: 8), Cycle 2: 2022-05-27 (Score: 8), Cycle 3: 2019-11-06 (Score: 16)
Total Weighted Health Score: 9.333
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 28, Total Fines in Dollars: 138661.25, Payment Denials Number: 0, Total Penalties Number: 28
Location and GPS: 35629 HIGHWAY 72,SALEM,MO,65560 (37.6582, -91.569)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-10-01
Type: Health, Deficiency: Provide care and assistance to perform activities of daily living for any resident who is unable.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-10-01
Type: Health, Deficiency: Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-10-01
Type: Health, Deficiency: Implement a program that monitors antibiotic use.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-10-01
Type: Health, Deficiency: Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-11
Type: Health, Deficiency: Have a plan that describes the process for conducting QAPI and QAA activities.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-11
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-12-18
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0015, Version: New
Description: Address subsistence needs for staff and patients.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-11
Type: Fire Safety, Tag: 0041, Version: New
Description: Implement emergency and standby power systems.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-11
Type: Fire Safety, Tag: 0712, Version: New
Description: Have simulated fire drills held at unexpected times.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-11