KING CITY MANOR

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265728 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER KING CITY MANOR STREET ADDRESS, CITY, STATE, ZIP 300 WEST FAIRVIEWKING CITY, MO …

KANSAS CITY CENTER FOR REHABILITATION AND HEALTHCARE

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265830 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER KANSAS CITY CENTER FOR REHABILITATION AND HEALTHCA STREET ADDRESS, CITY, STATE, ZIP 12942 …

JORDAN CREEK NURSING & REHAB

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265394 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER JORDAN CREEK NURSING & REHAB STREET ADDRESS, CITY, STATE, ZIP 910 SOUTH WEST …

JOPLIN HEALTH AND REHABILITATION CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265309 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER JOPLIN HEALTH AND REHABILITATION CENTER STREET ADDRESS, CITY, STATE, ZIP 2218 W 32ND …

JONESBURG NURSING & REHAB

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265333 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER JONESBURG NURSING & REHAB STREET ADDRESS, CITY, STATE, ZIP 308 CEDAR AVENUE, PO …

JEFFERSON CITY NURSING AND REHABILITATION CTR, LLC

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265530 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER JEFFERSON CITY NURSING AND REHABILITATION CTR, LLC STREET ADDRESS, CITY, STATE, ZIP 1221 …

INDEPENDENCE MANOR CARE CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265682 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER INDEPENDENCE MANOR CARE CENTER STREET ADDRESS, CITY, STATE, ZIP 1600 SOUTH KINGSHIGHWAYINDEPENDENCE, MO …

HILLSIDE MANOR HEALTHCARE AND REHAB CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265585 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER HILLSIDE MANOR HEALTHCARE AND REHAB CENTER STREET ADDRESS, CITY, STATE, ZIP 1265 MCLARAN …

HIGHLAND REHABILITATION & HEALTH CARE CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265167 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER HIGHLAND REHABILITATION & HEALTH CARE CENTER STREET ADDRESS, CITY, STATE, ZIP 904 EAST …

HERITAGE CARE CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265534 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER HERITAGE CARE CENTER STREET ADDRESS, CITY, STATE, ZIP 4401 NORTH HANLEY ROADSAINT LOUIS, …