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Dorothy Love Retirement Commun - Sidney Nursing Home

General Information

UPDATE
Federal Provider Number
365506
Provider Name
DOROTHY LOVE RETIREMENT COMMUN
Provider Address
3003 WEST CISCO ROAD
SIDNEY, OH 45365
Provider Phone Number
9374982391
Provider SSA County
760
Provider County Name
Shelby
Ownership Type
Non profit - Corporation
Number of Certified Beds
96
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
OPRS COMMUNITIES
Date First Approved to Provide Medicare and Medicaid services
1980-04-03
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.66739
Reported LPN Staffing Hours per Resident per Day
0.97065
Reported RN Staffing Hours per Resident per Day
1.03370
Reported Licensed Staffing Hours per Resident per Day
2.00435
Reported Total Nurse Staffing Hours per Resident per Day
4.67174
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03641
Expected CNA Staffing Hours per Resident per Day
2.44613
Expected LPN Staffing Hours per Resident per Day
0.69171
Expected RN Staffing Hours per Resident per Day
1.07917
Expected Total Nurse Staffing Hours per Resident per Day
4.21701
Adjusted CNA Staffing Hours per Resident per Day
2.67564
Adjusted LPN Staffing Hours per Resident per Day
1.16471
Adjusted RN Staffing Hours per Resident per Day
0.71571
Adjusted Total Nurse Staffing Hours per Resident per Day
4.46556
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-07-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
193
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
193
Total Weighted Health Survey Score
36.83300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
10725
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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