Parkdale Manor Care Center
814 West South Avenue, Maryville, MO 64468


Parkdale Manor Care Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 265591. The address is 814 West South Avenue, Maryville, MO 64468. The zip code is 64468. The phone number is 6605828161.


Parkdale Manor Care Center · 814 West South Avenue, Maryville, MO 64468

Federal Provider Number 265591
Provider Name PARKDALE MANOR CARE CENTER
Address 814 WEST SOUTH AVENUE
MARYVILLE, MO 64468
Phone Number 6605828161
SSA County Code 730
County Name Nodaway
Ownership Type For profit - Corporation
Certified Beds 92
Certified Beds Residents 42
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name PARKDALE MANOR INCORPORATED
Date First Approved to Provide Medicare Medicaid Services 11/01/1994
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 Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 4
Quality Measure Rating 2
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.35595
Reported LPN Staffing Hours per Resident per Day 0.65119
Reported RN Staffing Hours per Resident per Day 0.52857
Reported Licensed Staffing Hours per Resident per Day 1.17976
Reported Total Nurse Staffing Hours per Resident per Day 3.53571
Reported Physical Therapist Staffing Hours per Resident Per Day 0.01071
Expected CNA Staffing Hours per Resident per Day 2.08038
Expected LPN Staffing Hours per Resident per Day 0.60781
Expected RN Staffing Hours per Resident per Day 0.8208
Expected Total Nurse Staffing Hours per Resident per Day 3.50899
Adjusted CNA Staffing Hours per Resident per Day 2.77873
Adjusted LPN Staffing Hours per Resident per Day 0.88924
Adjusted RN Staffing Hours per Resident per Day 0.48117
Adjusted Total Nurse Staffing Hours per Resident per Day 4.0616
Cycle 1 Total Number of Health Deficiencies 3
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Number of Complaint Health Deficiencies 2
Cycle 1 Health Deficiency Score 12
Cycle 1 Standard Survey Health Date 05/04/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 12
Cycle 2 Total Number of Health Deficiencies 7
Cycle 2 Number of Standard Health Deficiencies 7
Cycle 2 Health Deficiency Score 36
Cycle 2 Standard Health Survey Date 04/07/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 36
Cycle 3 Total Number of Health Deficiencies 2
Cycle 3 Number of Standard Health Deficiencies 2
Cycle 3 Health Deficiency Score 24
Cycle 3 Standard Health Survey Date 06/17/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 24
Total Weighted Health Survey Score 22
Number of Substantiated Complaints 2
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Parkdale Manor Care Center

Owner Name Role Association Date
CARRITHERS, JIM (Individual) MANAGING EMPLOYEE since 06/01/2015
GIBSON, ANN (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/22/1968
JUCKETTE MANAGEMENT SERVICES SENIOR LIVING, INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 11/03/2015
JUCKETTE, CYNTHIA (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/03/2015
JUCKETTE, CYNTHIA (Individual) DIRECTOR since 11/03/2015
JUCKETTE, CYNTHIA (Individual) OFFICER since 11/03/2015
JUCKETTE, JAMES (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/03/2015
JUCKETTE, JAMES (Individual) DIRECTOR since 11/03/2015
JUCKETTE, JAMES (Individual) OFFICER since 11/03/2015
JUCKETTE, JON (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/03/2015
JUCKETTE, JON (Individual) DIRECTOR since 11/03/2015
JUCKETTE, JON (Individual) OFFICER since 11/03/2015
PARKDALE MANOR INCORPORATED (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 10/07/2011
SCHEULEN, BENJAMIN (Individual) OPERATIONAL/MANAGERIAL CONTROL since 09/12/2014

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