Englewood Manor Inc - Englewood Nursing Home
General Information
UPDATEFederal Provider Number
365088
Provider Name
ENGLEWOOD MANOR INC
Provider Address
425 LAURICELLA COURT
ENGLEWOOD, OH 45322
ENGLEWOOD, OH 45322
Provider Phone Number
9378365143
Provider SSA County
580
Provider County Name
Montgomery
Ownership Type
For profit - Corporation
Number of Certified Beds
125
Number of Residents in Certified Beds
101
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY NURSING CENTER OF ENGLEWOOD INC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
Continuing Care Retirement Community
N
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
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.23861
Reported LPN Staffing Hours per Resident per Day
0.94604
Reported RN Staffing Hours per Resident per Day
0.56188
Reported Licensed Staffing Hours per Resident per Day
1.50792
Reported Total Nurse Staffing Hours per Resident per Day
3.74653
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03465
Expected CNA Staffing Hours per Resident per Day
2.57467
Expected LPN Staffing Hours per Resident per Day
0.81325
Expected RN Staffing Hours per Resident per Day
1.55860
Expected Total Nurse Staffing Hours per Resident per Day
4.94652
Adjusted CNA Staffing Hours per Resident per Day
2.13343
Adjusted LPN Staffing Hours per Resident per Day
0.96553
Adjusted RN Staffing Hours per Resident per Day
0.26937
Adjusted Total Nurse Staffing Hours per Resident per Day
3.05303
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-03-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-12-19
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
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
8
Total Weighted Health Survey Score
10.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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