Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265762 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER ST JOSEPH SENIOR LIVING STREET ADDRESS, CITY, STATE, ZIP 1317 NORTH 36TH STREETSAINT …
ST JOHNS PLACE
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265733 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER ST JOHNS PLACE STREET ADDRESS, CITY, STATE, ZIP 3333 BROWN ROADSAINT LOUIS, MO …
ST JOE MANOR
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265701 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER ST JOE MANOR STREET ADDRESS, CITY, STATE, ZIP 10 LAKE DRIVEBONNE TERRE, MO …
ST JAMES LIVING CENTER
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265225 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER ST JAMES LIVING CENTER STREET ADDRESS, CITY, STATE, ZIP 415 SIDNEY STREET, PO …
SPRING VALLEY HEALTH & REHABILITATION CENTER
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265188 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER SPRING VALLEY HEALTH & REHABILITATION CENTER STREET ADDRESS, CITY, STATE, ZIP 2915 SOUTH …
SILVERSTONE PLACE
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265851 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER SILVERSTONE PLACE STREET ADDRESS, CITY, STATE, ZIP 2735 EAGLESON DRROLLA, MO 65401 For …
SILEX COMMUNITY CARE
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265611 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER SILEX COMMUNITY CARE STREET ADDRESS, CITY, STATE, ZIP 111 DUNCAN MANSION ROADSILEX, MO …
SHANGRI LA REHAB & LIVING CENTER
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265595 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER SHANGRI LA REHAB & LIVING CENTER STREET ADDRESS, CITY, STATE, ZIP 930 NE …
SHADY LAWN LIVING CENTER
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265846 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER SHADY LAWN LIVING CENTER STREET ADDRESS, CITY, STATE, ZIP 13277 STATE ROUTE DSAVANNAH, …
SEVILLE CARE CENTER
Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265521 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER SEVILLE CARE CENTER STREET ADDRESS, CITY, STATE, ZIP 35625 HIGHWAY 72, PO BOX …