Lake Stockton Healthcare Facility
811 Owen Mill Road, Po Box 945, Stockton, MO 65785


Lake Stockton Healthcare Facility is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 265466. The address is 811 Owen Mill Road, Po Box 945, Stockton, MO 65785. The zip code is 65785. The phone number is 4172765126.


Lake Stockton Healthcare Facility · 811 Owen Mill Road, Po Box 945, Stockton, MO 65785

Federal Provider Number 265466
Provider Name LAKE STOCKTON HEALTHCARE FACILITY
Address 811 OWEN MILL ROAD, PO BOX 945
STOCKTON, MO 65785
Phone Number 4172765126
SSA County Code 190
County Name Cedar
Ownership Type Non profit - Corporation
Certified Beds 75
Certified Beds Residents 59
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Date First Approved to Provide Medicare Medicaid Services 09/20/1991
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 5
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.54407
Reported LPN Staffing Hours per Resident per Day 0.6322
Reported RN Staffing Hours per Resident per Day 0.5839
Reported Licensed Staffing Hours per Resident per Day 1.2161
Reported Total Nurse Staffing Hours per Resident per Day 3.76017
Expected CNA Staffing Hours per Resident per Day 2.0846
Expected LPN Staffing Hours per Resident per Day 0.56316
Expected RN Staffing Hours per Resident per Day 0.79739
Expected Total Nurse Staffing Hours per Resident per Day 3.44515
Adjusted CNA Staffing Hours per Resident per Day 2.99453
Adjusted LPN Staffing Hours per Resident per Day 0.93176
Adjusted RN Staffing Hours per Resident per Day 0.54714
Adjusted Total Nurse Staffing Hours per Resident per Day 4.39948
Cycle 1 Standard Survey Health Date 03/10/2017
Cycle 2 Total Number of Health Deficiencies 2
Cycle 2 Number of Standard Health Deficiencies 2
Cycle 2 Health Deficiency Score 24
Cycle 2 Standard Health Survey Date 05/12/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 24
Cycle 3 Total Number of Health Deficiencies 2
Cycle 3 Number of Standard Health Deficiencies 2
Cycle 3 Health Deficiency Score 12
Cycle 3 Standard Health Survey Date 04/16/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 12
Total Weighted Health Survey Score 10
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Lake Stockton Healthcare Facility

Owner Name Role Association Date
BABB, DONALD (Individual) DIRECTOR since 09/24/1986
COSTELLO, KEVIN (Individual) MANAGING EMPLOYEE since 09/01/2011
DONNELL, WILLIAM (Individual) DIRECTOR since 03/14/2012
FULBRIGHT, GARY (Individual) OFFICER since 09/24/1986
GREGORY, BRADLEY (Individual) DIRECTOR since 07/01/1991
GREGORY, BRADLEY (Individual) OFFICER since 07/01/1991
HUNTER, DEREK (Individual) DIRECTOR since 07/01/2007
JOHNSON, NEALE (Individual) DIRECTOR since 08/18/2011
MEENTS, DANA (Individual) DIRECTOR since 10/14/2010
MEYER, RENEE (Individual) MANAGING EMPLOYEE since 07/01/1997
MOLDER, CATHERINE (Individual) OFFICER since 03/01/2002
PAYNE, RUSSEL (Individual) DIRECTOR since 02/16/2012
STRADER, DAVE (Individual) DIRECTOR since 07/01/1991
STRADER, DAVE (Individual) OFFICER since 07/01/1991

Stockton · Nursing Home

Kindred Transitional Care & Rehab - Valley Gardens 1517 East Knickerbocker Drive, Stockton, CA 95210
Solomon Valley Manor 315 S Ash St, Stockton, KS 67669
La Salette Health and Rehabilitation Center 537 E. Fulton Street, Stockton, CA 95204
Crestwood Manor - 104 1130 Monaco Court, Stockton, CA 95207
Riverwood Healthcare Center 5320 Carrington Circle, Stockton, CA 95210
Waverly Place of Stockton 501 East Front Street, Po Box #38, Stockton, IL 61085
Golden Living Center - Chateau 1221 Rosemarie Lane, Stockton, CA 95207
Meadowood A Health and Rehabilitation Center 3110 Wagner Heights Road, Stockton, CA 95209
Golden Living Center - Portside 2740 North California Street, Stockton, CA 95204
Lincoln Square Post Acute Care 1032 N. Lincoln Street, Stockton, CA 95203
Windsor Elmhaven Care Center 6940 Pacific Avenue, Stockton, CA 95207
Windsor Hampton Care Center 442 Hampton Street, Stockton, CA 95204
Wagner Heights Nursing & Rehabilitation Center 9289 Branstetter Place, Stockton, CA 95209
Golden Living Center - Hy-pana 4545 Shelley Court, Stockton, CA 95207
Good Samaritan Rehab and Care Center 1630 N. Edison Street, Stockton, CA 95204
Plymouth Square 1319 N. Madison Street, Stockton, CA 95202
Creekside Center 9107 N. Davis Road, Stockton, CA 95209

MO · Nursing Home

Kabul Nursing Homes Inc 1000 Main Street, Cabool, MO 65689
Tarkio Rehabilitation & Health Care 300 Cedar Street, Tarkio, MO 64491
Carthage Health and Rehabilitation Center 1901 Buena Vista Avenue, Carthage, MO 64836
Jordan Creek Nursing & Rehab 910 South West Ave, Springfield, MO 65802
Bethesda Dilworth 9645 Big Bend Blvd, Saint Louis, MO 63122
Living Center, The 2506 Linden Tree Parkway, Po Box 370, Marshall, MO 65340
Lutheran Convalescent Home 723 South Laclede Station Rd, Webster Groves, MO 63119
Nazareth Living Center #2 Nazareth Lane, Saint Louis, MO 63129
Pleasant View 470 Rainbow Drive, Po Box 273, Rock Port, MO 64482
Bentonview Park Health & Rehabilitation 410 West Benton Street, Monett, MO 65708
Pemiscot County Memorial Hospital Po Box 489, Highway 61 and Reed Street, Hayti, MO 63851
Fair View Nursing Home 1714 W 16th Street, Sedalia, MO 65301
Katy Manor 205 Prospect, Po Box 8, Pilot Grove, MO 65276
Ballwin Ridge Health & Rehabilitation 1441 Charic Drive, Wildwood, MO 63021
River City Living Community 3038 West Truman Blvd, Jefferson City, MO 65109
Ratliff Care Center 717 North Sprigg, Cape Girardeau, MO 63701
Strafford Care Center 505 West Evergreen, Strafford, MO 65757
Brookhaven Nursing & Rehab 3405 West Mt Vernon, Springfield, MO 65802
Ozarks Methodist Manor, The 205 South College, Po Box 403, Marionville, MO 65705
Nhc Healthcare, Joplin 2700 East 34th Street, Po Box 2877, Joplin, MO 64803
Mark Twain Manor 11988 Mark Twain Lane, Bridgeton, MO 63044
Holden Manor Care Center 2005 South Lexington, Holden, MO 64040
Medicalodges Butler 103 East Nursery, Butler, MO 64730
Excelsior Springs Nursing & Rehab 1003 Meadowlark Lane, Excelsior Springs, MO 64024
Hillside Manor Healthcare and Rehab Center 1265 Mclaran Avenue, Saint Louis, MO 63147
Big Bend Woods Healthcare Center 110 Highland Avenue, Valley Park, MO 63088
Delmar Gardens North 4401 Parker Road, Black Jack, MO 63033
Gerald Nursing and Rehab 533 Canaan Road, Po Box 180, Gerald, MO 63037
St Joseph's Bluffs 1306 West Main Street, Jefferson City, MO 65109
Shady Lawn Living Center 13277 State Route D, Savannah, MO 64485
Tri-county Care Center 601 North Galloway Road, Vandalia, MO 63382
Lincoln Community Care Center 205 Timberline Drive, Lincoln, MO 65338
Seasons Care Center 15600 Woods Chapel Road, Kansas City, MO 64139
La Verna Village Nursing Home 904 Hall Avenue, Po Box 279, Savannah, MO 64485
Carrie Elligson Gietner Home 5000 South Broadway, Saint Louis, MO 63111
Highland Rehabilitation & Health Care Center 904 East 68th Street, Kansas City, MO 64131
Knox County Nursing Home District 55774 State Highway 6, Edina, MO 63537
Scenic Nursing and Rehabilitation Center, LLC 1333 Scenic Drive, Herculaneum, MO 63048
Sunset Home 1201 S. Polk, Maysville, MO 64469
King City Manor 300 West Fairview, King City, MO 64463