CHEYENNE COUNTY VILLAGE INC

Continuing care retirement community · CCN 175347 · CHEYENNE COUNTY VILLAGE INC · Non profit - Corporation · GRACE TEAM SERVICES chain · 30 certified beds · Cheyenne · KS


CHEYENNE COUNTY VILLAGE INC is a 30-bed nursing home in ST FRANCIS, Kansas. CMS has certified it for Medicare and Medicaid since 1995-06-01. It averages 27.9 residents a day.

What harm was found in the violations cited at CHEYENNE COUNTY VILLAGE INC?

CMS lists 31 health-inspection deficiencies for CHEYENNE COUNTY VILLAGE INC since 2021-07-28, 11 of them in the three years to 2026-08-01: the highest scope-and-severity letter on record is J; the most recent health inspection was 2024-04-03.

Survey dateTagDeficiencySeverity
2024-04-03F0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.J
2024-04-03F0697Provide safe, appropriate pain management for a resident who requires such services.G
2023-09-28F0812, F0851, F0868Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. / Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. / Have the Quality Assessment and Assurance group have the required members and meet at least quarterlyF
2023-09-28F0550, F0656, F0658, F0690, F0726, F0880Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. / Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. / Ensure services provided by the nursing facility meet professional standards of quality. / Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. / Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. / Provide and implement an infection prevention and control program.D
2022-10-13F0881Implement a program that monitors antibiotic use.F
2022-10-13F0580, F0609, F0610, F0656, F0657, F0660, F0676, F0677, F0684, F0689, F0690, F0726, F0744, F0758Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. / Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. / Respond appropriately to all alleged violations. / Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. / Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. / Plan the resident's discharge to meet the resident's goals and needs. / Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. / Provide care and assistance to perform activities of daily living for any resident who is unable. / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. / Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. / Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. / Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. / Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.D
2021-07-28F0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E
2021-07-28F0657, F0689, F0758Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. / Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. / Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.D
2021-07-28F0577Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.C

Why was CHEYENNE COUNTY VILLAGE INC fined?

DateTypeAmount
2024-04-03Fine$13,287

How is CHEYENNE COUNTY VILLAGE INC staffed relative to the KS average?

MeasureThis facilityKS average
Total nurse staffing hours per resident per day3.908864.06686
Total nursing staff turnover (%)39.348.1
Average number of residents per day27.950.5

Who owns CHEYENNE COUNTY VILLAGE INC, and what chain is it in?

CHEYENNE COUNTY VILLAGE INC is registered with CMS as Non profit - Corporation, operates under the legal business name CHEYENNE COUNTY VILLAGE INC and belongs to the GRACE TEAM SERVICES chain.

RoleOwnerAssociation date
5% OR GREATER DIRECT OWNERSHIP INTERESTCHEYENNE COUNTY VILLAGE INCsince 11/01/2018
DIRECT OWNERSHIP INTERESTKLEPPER, RODsince 11/01/2018
CORPORATE DIRECTORCARMICHAEL, SHERRY, HOUTMAN, SARA, KELLER, THOMAS, SCHULTZ, EDDYsince 11/01/2018
CORPORATE OFFICERKLEPPER, ROD, LOHR, BROOKEsince 01/01/2021
OPERATIONAL/MANAGERIAL CONTROLCHEYENNE COUNTY VILLAGE INC, GRACE TEAM LLC, GT SERVICES LLC, GRACE, RYAN, HUEBERT, ERIC, LICKE, HEATHER, MCTAGUE, DAPHNEsince 02/01/2021
ADP OF THE SNFCOUNTY OF CHEYENNE, GRACE TEAM LLC, GT SERVICES LLC, GRACE, RYAN, HUEBERT, ERIC, LICKE, HEATHER, MCTAGUE, DAPHNEsince 02/01/2021

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