BENCHMARK HEALTHCARE OF WILLOWBROOKE

The information listed below provides an in-depth look into the type and quality of care offered at Benchmark Healthcare of Willowbrooke. It is important to note that when evaluating if a nursing home is right for you or a loved one, ratings should not be taken as the sole deciding factor, but as one of many aspects to be considered.

Address

BENCHMARK HEALTHCARE OF WILLOWBROOKE
2600 REDMAN ROAD
SAINT LOUIS, MO 63136
(314) 355-8585

Nursing Home Ratings

Health Inspections
Quality Measures
Nursing Staff
R.N. Staff Only
Overall Rating

Percent of Beds Occupied

64%

Number of Residents and Certified Beds

  • Residents: 77
  • Certified Beds: 120

This Facility Accepts

  • Medicare
  • Medicaid

Operational Details

  • Operated By For Profit - Corporation
  • Offers Only Resident Counseling
  • This Facility is Not Part of a Chain or Franchise

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Resident Services

The information below lists services this facility has provided for residents from October through December 2010. During this period, the most common type of service provided was "High Rehabilitation". To get a better idea of the types of services that are commonly performed, compare the "Percent of Service Days" column below. These services are based on submitted claims to Medicare and do not provide a complete overview of all the services provided by Benchmark Healthcare of Willowbrooke. For more information read our guide on how nursing facilities are reimbursed, types of services, and ADL index scores.

Resident ServicesResident ConditionsPercent of Service Days

Very High Rehabilitation Plus Extensive Services

Rehabilitation 500 Minutes Per Week Minimum
  • At least one rehabilitation discipline five days/week
  • Tracheostomy care
  • Ventilator or respirator
  • Isolation for active infectious disease while a resident
  • Activities of Daily Living (ADL) score of 2 or more
ADL Index Range: 11-1617.1%
ADL Index Range: 2-102.7%
Total Percent:19.8%
 

Very High Rehabilitation

Rehabilitation 500 Minutes Per Week Minimum
  • At least one rehabilitation discipline five days/week
ADL Index Range: 6-109.0%
ADL Index Range: 0-58.3%
Total Percent:17.3%
 

High Rehabilitation

Rehabilitation 325 Minutes Per Week Minimum
  • At least one rehabilitation discipline five days/week
ADL Index Range: 11-1612.9%
ADL Index Range: 0-521.5%
Total Percent:34.4%
 

Medium Rehabilitation

Rehabilitation 150 Minutes Per Week Minimum
  • Five days any combination of three rehabilitation disciplines
ADL Index Range: 0-517.6%
Total Percent:17.6%
 

Extensive Services

  • Tracheostomy care
  • Ventilator or respirator
  • Isolation for active infectious disease while a resident
  • Activities of Daily Living (ADL) score of 2 or more
ADL Index Range: 2-16
- Tracheostomy care or ventilator/respirator
0.7%
Total Percent:0.7%
 

Special Care Low

  • Cerebral palsy, multiple sclerosis, or Parkinson's disease with ADL score greater or equal to 5
  • Respiratory failure and oxygen therapy while a resident
  • Feeding tube where calories >= 51% or calories are in the range of 26-50% and fluid >= 501 mL)
  • Ulcers: 2 or more stage II or 1 or more stage III or IV pressure ulcers
  • Ulcers: 2 or more venous or arterial ulcers
  • Ulcers: 1 stage II pressure ulcer and 1 venous or arterial ulcer with 2 or more skin care treatments
  • Foot infection/diabetic foot ulcer/open lesions of foot with treatment
  • Radiation therapy while a resident
  • Dialysis while a resident
  • Activities of Daily Living (ADL) score of 2 or more
ADL Index Range: 2-5
- No Signs of depression
10.2%
Total Percent:10.2%
 

Rating Details For Benchmark Healthcare of Willowbrooke

Nursing Staff -

The nursing staff is the most important part of what determines the quality of care and comfort of a resident in a nursing home. Government regulations set expectations on time spent with each resident based on the services being provided. The breakdown below lists the nursing types (RN, LPN, LVN, CNA) and a comparison of the reported and expected hours per resident per day.

Nursing Hours Per Resident Per DayReportedExpected
Registered Nurse (RN) Hours40 Minutes1 Hour and 8 Minutes
Licensed Practical/Vocational Nurse (LPN/LVN) Hours28 Minutes42 Minutes
Certified Nursing Assistant (CNA) Hours2 Hours and 14 Minutes2 Hours and 16 Minutes
Total Licensed Nurse Hours1 Hour and 8 Minutes1 Hour and 49 Minutes
Total Nurse Hours3 Hours and 22 Minutes4 Hours and 5 Minutes

Quality of Care -

Medicare determines quality of care ratings for nursing facilities by surveying several "quality measures", which are broken down into long-term and short-term stay residents, as well as if the action is preventive or if there is a deficiency in the quality of care. State averages for Missouri are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

This FacilityMissouri Average

Long-Term Stay Preventive Actions

Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination51%88%
Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season64%93%

Long-Term Stay Deficiencies

Percent of High-Risk Long-Stay Residents Who Have Pressure Sores7%10%
Percent of Long-Stay Residents Who Have Moderate to Severe Pain5%4%
Percent of Long-Stay Residents Who Were Physically Restrained2%4%
Percent of Long-Stay Residents Who Lose Too Much Weight6%7%
Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse4%9%
Percent of Long-Stay Residents Who Are More Depressed or Anxious5%11%
Percent of Long-Stay Residents Who Had a Urinary Tract Infection7%9%
Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder4%5%
Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair1%3%
Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder53%38%
Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased3%11%
Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores2%3%

Short-Term Stay Preventive Actions

Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season74%87%
Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination65%83%

Short-Term Stay Deficiencies

Percent of Short-Stay Residents Who Have Delirium5%4%
Percent of Short-Stay Residents Who Have Pressure Sores29%11%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain19%20%

Health Inspection Details -

All Medicare and/or Medicaid certified nursing home must undergo health inspections on average once a year, but may be more frequent if the facility is peforming poorly. These inspections cover most aspects of life in a nursing home, and are broken down into deficiencies types, which including: Pharmacy Service, Administration, Resident Rights, Nutrition and Dietary, Resident Assessment, Environmental, and Mistreatment. Below are the list of deficiencies found by inspectors in the past few years along with the degree of harm and how many residents may have been affected. Note: The most recent health survey was on 08/11/2010.

Degree of Harm

  • - Potential for Minimal Harm
  • - Minimal Harm or Potential for Harm
  • - Resident Harmed
  • - Immediate Jeopardy to Resident Health

Residents Affected

  • - Isolated
  • - Some Residents
  • - Many Residents
Deficiencies Found By InspectorsDegree of HarmResidents Affected

Administration

Give or Get Lab Tests by a Certified Laboratory.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
1) Review the Work of Each Nurse Aide Every Year; or 2) Give Regular Training for the Nurse Aides.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010

Environmental

Keep Sound Levels Comfortable.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Have a Program to Keep Infection from Spreading.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure That the Nursing Home Area is Safe, Easy to Use, Clean and Comfortable.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Have a Program to Keep Infection from Spreading.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Make Sure There is a Program to Prevent/Deal with Mice, Insects, or Other Pests.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009

Mistreatment

Keep Each Resident Free from Physical Restraints, Unless Needed for Medical Treatment.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009

Nutrition and Dietary

Store, Cook, and Give out Food in a Safe and Clean Way.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Store, Cook, and Give out Food in a Safe and Clean Way.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Store, Cook, and Give out Food in a Safe and Clean Way.
  • Inspection Date: 08/11/2010
  • Correction Date: 11/09/2010

Pharmacy Service

1) Make Sure That Residents Who Take Drugs Are Not Given Too Many Doses or for Too Long; 2) Make Sure That the Use of Drugs is Carefully Watched; or 3) Stop or Change Drugs That Cause Unwanted Effects.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
At Least Once a Month, Have a Licensed Pharmacist Check the Drugs That Each Resident Takes.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010

Quality Care

Provide Activities to Meet the Needs of Each Resident.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure That Residents with Reduced Range of Motion Get Proper Treatment and Services to Increase Range of Motion.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Give the Right Treatment and Services to Residents Who Have Mental or Social Problems Adjusting.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Give Proper Treatment to Residents with Feeding Tubes to Prevent Problems (Such As Aspiration Pneumonia, Diarrhea, Vomiting, Dehydration, Metabolic Abnormalities, Nasal-Pharyngeal Ulcers) and Help Restore Eating Skills, if Possible.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Develop/Implement Required Procedures for the Administration of Immunizations.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Give Professional Services That Meet a Professional Standard of Quality.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene.
  • Inspection Date: 08/11/2010
  • Correction Date: 11/09/2010
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores.
  • Inspection Date: 08/11/2010
  • Correction Date: 11/09/2010
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary.
  • Inspection Date: 08/11/2010
  • Correction Date: 11/09/2010
Give Proper Treatment to Residents with Feeding Tubes to Prevent Problems (Such As Aspiration Pneumonia, Diarrhea, Vomiting, Dehydration, Metabolic Abnormalities, Nasal-Pharyngeal Ulcers) and Help Restore Eating Skills, if Possible.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010
Make Sure That Each Resident's Nutritional Needs Were Met.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010
Properly Care for Residents Needing Special Services, Including: Injections, Colostomy, Ureostomy, Ileostomy, Tracheostomy Care, Tracheal Suctioning, Respiratory Care, Foot Care, and Prostheses.
  • Inspection Date: 08/11/2010
  • Correction Date: 11/09/2010

Resident Assessment

Do an Assessment of the Resident Every Year.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Check and Update (If Needed) Each Resident's Assessment Every 3 Months.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Keep Assessments Completed in the Preceding 15 Months in the Resident's Active Record.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Electronically Record and Report Resident Status Assessments in a Timely Manner As Required in Order to Monitor Resident Health and Progress.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure That All Needed Doctor Visits Are Made Personally by a Doctor, As Required.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008

Resident Rights

Properly Hold, Secure and Manage Each Resident's Personal Money Which is Deposited with the Nursing Home.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Keep Each Resident's Personal and Medical Records Private and Confidential.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Listen to the Resident or Family Groups or Act on Their Complaints or Suggestions.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Provide Care in a Way That Keeps or Builds Each Resident's Dignity and Self Respect.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Properly Hold, Secure and Manage Each Resident's Personal Money Which is Deposited with the Nursing Home.
  • Inspection Date: 08/11/2010
  • Correction Date: 01/18/2011

Enforcement

Below is a list of any civil penalities or denials of payment for new admissions (DPNA) that this facility received in the previous three years. Note: Monetary figures are not available for DPNAs.

Action TakenDateAmount
Denial of Payment for New Admission (DPNA)08/11/2010-

Deficiencies from Complaints and Incidents

The table below lists incident reports by the nursing staff or administration for Benchmark Healthcare of Willowbrooke, as well as complaints by residents or their family in the previous three years.

Degree of Harm

  • - Potential for Minimal Harm
  • - Minimal Harm or Potential for Harm
  • - Resident Harmed
  • - Immediate Jeopardy to Resident Health

Residents Affected

  • - Isolated
  • - Some Residents
  • - Many Residents
Formal ComplaintsDegree of HarmResidents Affected

Environmental

Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents.
  • Complaint Filed: 05/09/2008
  • Correction Date: 06/16/2008
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents.
  • Complaint Filed: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure There is a Program to Prevent/Deal with Mice, Insects, or Other Pests.
  • Complaint Filed: 09/04/2008
  • Correction Date: 10/16/2008
Provide Needed Housekeeping and Maintenance.
  • Complaint Filed: 09/04/2008
  • Correction Date: 10/16/2008
Make Sure That the Nursing Home Area is Safe, Easy to Use, Clean and Comfortable.
  • Complaint Filed: 02/03/2010
  • Correction Date: 03/26/2010
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents.
  • Complaint Filed: 08/11/2010
  • Correction Date: 01/18/2011
Have a Program to Keep Infection from Spreading.
  • Complaint Filed: 08/11/2010
  • Correction Date: 11/09/2010
Make Sure There is a Program to Prevent/Deal with Mice, Insects, or Other Pests.
  • Complaint Filed: 08/11/2010
  • Correction Date: 09/14/2010
Provide Needed Housekeeping and Maintenance.
  • Complaint Filed: 08/11/2010
  • Correction Date: 09/14/2010
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents.
  • Complaint Filed: 11/10/2010
  • Correction Date: 01/18/2011

Mistreatment

1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents.
  • Complaint Filed: 09/04/2008
  • Correction Date: 10/16/2008

Pharmacy Service

Have Drugs and Other Similar Products Available, Which Are Needed Every Day and in Emergencies, and Give Them out Properly.
  • Complaint Filed: 07/13/2009
  • Correction Date: 08/18/2009

Quality Care

Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores.
  • Complaint Filed: 05/09/2008
  • Correction Date: 07/03/2008
Give Professional Services That Meet a Professional Standard of Quality.
  • Complaint Filed: 05/09/2008
  • Correction Date: 07/03/2008
Give Professional Services That Meet a Professional Standard of Quality.
  • Complaint Filed: 09/04/2008
  • Correction Date: 10/16/2008
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible.
  • Complaint Filed: 09/04/2008
  • Correction Date: 10/16/2008
Give Professional Services That Meet a Professional Standard of Quality.
  • Complaint Filed: 07/13/2009
  • Correction Date: 08/18/2009
Give Professional Services That Meet a Professional Standard of Quality.
  • Complaint Filed: 02/03/2010
  • Correction Date: 03/26/2010
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores.
  • Complaint Filed: 02/03/2010
  • Correction Date: 03/26/2010
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible.
  • Complaint Filed: 12/07/2010
  • Correction Date: 01/18/2011

Resident Rights

Provide Care in a Way That Keeps or Builds Each Resident's Dignity and Self Respect.
  • Complaint Filed: 09/04/2008
  • Correction Date: 10/16/2008

Fire Safety

Nursing homes certified by Medicare and/or Medicaid are required to have fire safety inspections to meet Life Safety Code (LSC) standards. Below is a list of deficiencies that Benchmark Healthcare of Willowbrooke had in recent fire safety inspections. This information can be used to see if all standards were met, the degree of harm, the number of residents affected, and the date when deficiencies were corrected. Note: The most recent fire safety survey was on 08/11/2010.

Degree of Harm

  • - Potential for Minimal Harm
  • - Minimal Harm or Potential for Harm
  • - Resident Harmed
  • - Immediate Jeopardy to Resident Health

Residents Affected

  • - Isolated
  • - Some Residents
  • - Many Residents
Deficiencies Found By InspectorsDegree of HarmResidents Affected

Automatic Sprinkler Systems

An Approved Automatic Sprinkler System Connected to the Fire Alarm System.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Automatic Sprinkler Systems That Have Been Maintained in Working Order.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Portable Fire Extinguishers.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Automatic Sprinkler Systems That Have Been Maintained in Working Order.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010

Building Construction

Approved Construction Type or Materials.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008

Corridor Walls and Doors

Corridor and Hallway Doors That Block Smoke.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Corridor and Hallway Doors That Block Smoke.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010

Electrical

Weekly Inspections and Monthly Testing of Generators.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Properly Installed Electrical Wiring and Equipment.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Weekly Inspections and Monthly Testing of Generators.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010

Emergency Plans and Fire Drills

Record of Quarterly Fire Drills for Each Shift Under Varying Conditions.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009

Exits and Egress

Exits That Are Accessible at All Times.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Exits That Are Accessible at All Times.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010

Fire Alarm Systems

Properly Maintained Smoke Detectors.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009

Furnishings and Decorations

Properly Sized and Located Linen or Trash Receptacles.
  • Inspection Date: 08/11/2010
  • Correction Date: 11/09/2010

Hazardous Area

Construction That Can Resist Fire for One Hour or an Approved Fire Extinguishing System.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Construction That Can Resist Fire for One Hour or an Approved Fire Extinguishing System.
  • Inspection Date: 08/11/2010
  • Correction Date: 09/14/2010

Illumination and Emergency Power

Emergency Lighting That Can Last at Least 1 1/2 Hours.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008

Medical Gases and Anesthetizing Areas

Proper Medical Gas Storage and Administration Areas.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009

Miscellaneous

Fire Safety Features Required by Current Fire Safety Codes.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008

Smoking Regulations

Posted "No-Smoking" Signs in Areas Where Smoking is Not Permitted or Did Not Provide Ashtrays Where Smoking Was Allowed.
  • Inspection Date: 09/04/2008
  • Correction Date: 10/16/2008
Posted "No-Smoking" Signs in Areas Where Smoking is Not Permitted or Did Not Provide Ashtrays Where Smoking Was Allowed.
  • Inspection Date: 07/13/2009
  • Correction Date: 08/18/2009
Source: Medicare Nursing Home Compare; Missouri Department of Health & Senior Services - Retrieved 2011