{
 "id": "175347",
 "kind": "snf",
 "kind_label": "Nursing home",
 "name": "Cheyenne County Village INC",
 "slug": "cheyenne-county-village-inc",
 "path": "/ks/cheyenne/st-francis/cheyenne-county-village-inc",
 "address": {
  "street": "820 S DENISON STREET",
  "city": "ST Francis",
  "county": "Cheyenne",
  "state": "KS",
  "state_name": "Kansas",
  "zip": "67756"
 },
 "phone": "7853322531",
 "coords": [
  39.766799,
  -101.79881
 ],
 "capacity": 30,
 "residents_per_day": 27.9,
 "status": "Medicare and Medicaid",
 "licensee": "Cheyenne County Village INC",
 "administrator": null,
 "licensed_since": "1995-06-01",
 "last_visit": "2023-09-28",
 "visits_total": null,
 "citations": {
  "type_a": null,
  "type_b": null,
  "basis": "Not applicable: certified federally, not cited by the state"
 },
 "citations_by_visit_type": {
  "complaint": {
   "visits": null,
   "type_a": null,
   "type_b": null
  },
  "inspection": {
   "visits": null,
   "type_a": null,
   "type_b": null
  },
  "other": {
   "visits": null,
   "type_a": null,
   "type_b": null
  }
 },
 "allegations": {
  "substantiated": null,
  "inconclusive": null,
  "unsubstantiated": null,
  "unfounded": null,
  "investigated": null
 },
 "capabilities": {},
 "capabilities_raw": null,
 "reports_on_file": 0,
 "reports": [],
 "federal": {
  "ownership_type": "Non profit - Corporation",
  "chain": "GRACE TEAM SERVICES",
  "in_hospital": false,
  "ccrc": true,
  "abuse_icon": false,
  "special_focus": null,
  "ratings": {
   "overall": 2,
   "health_inspection": 2,
   "staffing": 3,
   "quality": 3
  },
  "cycle1": {
   "date": "2023-09-28",
   "total": 9,
   "standard": 9,
   "complaint": 0
  },
  "fines": {
   "count": 1,
   "dollars": 13287,
   "penalties": 1
  },
  "staffing": {
   "nurse_hours_per_resident_day": 3.90886,
   "turnover_pct": 39.3
  },
  "on_record": {
   "immediate_jeopardy": 1,
   "actual_harm": 1,
   "potential_harm": 28,
   "minimal": 1
  },
  "penalties_on_file": {
   "count": 1,
   "dollars": 13287
  },
  "owners": [
   {
    "name": "CHEYENNE COUNTY VILLAGE INC",
    "role": "Organization",
    "since": "since 11/01/2018",
    "share": "100%"
   },
   {
    "name": "KLEPPER, ROD",
    "role": "Individual",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "CARMICHAEL, SHERRY",
    "role": "Individual",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "HOUTMAN, SARA",
    "role": "Individual",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "KELLER, THOMAS",
    "role": "Individual",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "SCHULTZ, EDDY",
    "role": "Individual",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "KLEPPER, ROD",
    "role": "Individual",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "LOHR, BROOKE",
    "role": "Individual",
    "since": "since 01/01/2021",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "CHEYENNE COUNTY VILLAGE INC",
    "role": "Organization",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "GRACE TEAM LLC",
    "role": "Organization",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "GT SERVICES LLC",
    "role": "Organization",
    "since": "since 11/01/2019",
    "share": "NOT APPLICABLE"
   },
   {
    "name": "GRACE, RYAN",
    "role": "Individual",
    "since": "since 11/01/2018",
    "share": "NOT APPLICABLE"
   }
  ]
 },
 "deficiencies": [
  {
   "date": "2024-04-03",
   "tag": "0686",
   "sev": "J",
   "complaint": true
  },
  {
   "date": "2024-04-03",
   "tag": "0697",
   "sev": "G",
   "complaint": true
  },
  {
   "date": "2023-09-28",
   "tag": "0812",
   "sev": "F",
   "complaint": false
  },
  {
   "date": "2023-09-28",
   "tag": "0851",
   "sev": "F",
   "complaint": false
  },
  {
   "date": "2023-09-28",
   "tag": "0868",
   "sev": "F",
   "complaint": false
  },
  {
   "date": "2023-09-28",
   "tag": "0550",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2023-09-28",
   "tag": "0656",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2023-09-28",
   "tag": "0658",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2023-09-28",
   "tag": "0690",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2023-09-28",
   "tag": "0726",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2023-09-28",
   "tag": "0880",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0881",
   "sev": "F",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0580",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0609",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0610",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0656",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0657",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0660",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0676",
   "sev": "D",
   "complaint": false
  },
  {
   "date": "2022-10-13",
   "tag": "0677",
   "sev": "D",
   "complaint": false
  }
 ],
 "source": {
  "name": "Centers for Medicare & Medicaid Services, Nursing Home Care Compare",
  "retrieved": "2026-07-29",
  "licence_number": "175347"
 }
}