Lutheran Senior Services At Breeze Park
600 Breeze Park Drive, Saint Charles, MO 63304


Lutheran Senior Services At Breeze Park is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 265767. The address is 600 Breeze Park Drive, Saint Charles, MO 63304. The zip code is 63304. The phone number is 6369395223.


Lutheran Senior Services At Breeze Park · 600 Breeze Park Drive, Saint Charles, MO 63304

Federal Provider Number 265767
Provider Name LUTHERAN SENIOR SERVICES AT BREEZE PARK
Address 600 BREEZE PARK DRIVE
SAINT CHARLES, MO 63304
Phone Number 6369395223
SSA County Code 910
County Name St. Charles
Ownership Type Non profit - Church related
Certified Beds 81
Certified Beds Residents 80
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name LUTHERAN SENIOR SERVICES
Date First Approved to Provide Medicare Medicaid Services 01/02/2004
Continuing Care Retirement Community true
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 4
Staffing Rating 3
RN Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 2.84125
Reported LPN Staffing Hours per Resident per Day 1.38938
Reported RN Staffing Hours per Resident per Day 0.53813
Reported Licensed Staffing Hours per Resident per Day 1.9275
Reported Total Nurse Staffing Hours per Resident per Day 4.76876
Reported Physical Therapist Staffing Hours per Resident Per Day 0.075
Expected CNA Staffing Hours per Resident per Day 2.42238
Expected LPN Staffing Hours per Resident per Day 0.63277
Expected RN Staffing Hours per Resident per Day 1.15368
Expected Total Nurse Staffing Hours per Resident per Day 4.20882
Adjusted CNA Staffing Hours per Resident per Day 2.87799
Adjusted LPN Staffing Hours per Resident per Day 1.82244
Adjusted RN Staffing Hours per Resident per Day 0.34853
Adjusted Total Nurse Staffing Hours per Resident per Day 4.56717
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 8
Cycle 1 Standard Survey Health Date 02/02/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 8
Cycle 2 Total Number of Health Deficiencies 8
Cycle 2 Number of Standard Health Deficiencies 6
Cycle 2 Number of Complaint Health Deficiencies 2
Cycle 2 Health Deficiency Score 60
Cycle 2 Standard Health Survey Date 01/21/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 60
Cycle 3 Total Number of Health Deficiencies 3
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Health Deficiency Score 4
Cycle 3 Standard Health Survey Date 10/30/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 4
Total Weighted Health Survey Score 24.667
Number of Substantiated Complaints 2
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Lutheran Senior Services At Breeze Park

Owner Name Role Association Date
BAGY, RICHARD (Individual) DIRECTOR since 04/27/2010
BARR, NORMA (Individual) DIRECTOR since 04/27/2010
BAUM, CARLA (Individual) DIRECTOR since 11/01/2009
BAUM, CARLA (Individual) MANAGING EMPLOYEE since 11/01/2009
BODENDIECK, LEE (Individual) DIRECTOR since 04/22/2008
CHRISTIANSEN, JOEL (Individual) DIRECTOR since 06/27/2011
DANKENBRING, JAMES (Individual) DIRECTOR since 09/13/2004
DROLLINGER, DIANE (Individual) DIRECTOR since 03/24/2014
DUNAJCIK, KARL (Individual) DIRECTOR since 04/28/2009
HARTWIG, SCOTT (Individual) DIRECTOR since 04/27/2010
KOMLOS, JOHN (Individual) DIRECTOR since 04/23/2013
KOTOVSKY, JOHN (Individual) DIRECTOR since 09/17/2007
KOTOVSKY, JOHN (Individual) MANAGING EMPLOYEE since 09/17/2007
LUCAS, WILLIAM (Individual) DIRECTOR since 11/25/2013
LUTHERAN SENIOR SERVICES (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 02/02/2000
LUTHERAN SENIOR SERVICES (Organization) OPERATIONAL/MANAGERIAL CONTROL since 02/02/2000
MUELLER, KATHLEEN (Individual) DIRECTOR since 04/27/2010
OGIER, PAUL (Individual) MANAGING EMPLOYEE since 07/01/2003
RASO, MICHAEL (Individual) MANAGING EMPLOYEE since 04/01/2013
RASO, MICHAEL (Individual) OFFICER since 04/03/2006
ROBINSON-RAINEY, CARLA (Individual) DIRECTOR since 04/28/2009
ROTH, WILLIAM (Individual) DIRECTOR since 04/22/2008
SIMMONS, WILLIAM (Individual) DIRECTOR since 04/22/2008
STEVENS, HOLLY (Individual) MANAGING EMPLOYEE since 11/13/2011
WALDEN, HENRY (Individual) DIRECTOR since 04/28/2009

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