Friendship Village - Dayton Nursing Home
General Information
UPDATEFederal Provider Number
365309
Provider Name
FRIENDSHIP VILLAGE
Provider Address
5790 DENLINGER ROAD
DAYTON, OH 45426
DAYTON, OH 45426
Provider Phone Number
9378375581
Provider SSA County
580
Provider County Name
Montgomery
Ownership Type
For profit - Corporation
Number of Certified Beds
127
Number of Residents in Certified Beds
112
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DAYTON SENIOR CARE LLC
Date First Approved to Provide Medicare and Medicaid services
1974-09-17
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.60179
Reported LPN Staffing Hours per Resident per Day
0.90313
Reported RN Staffing Hours per Resident per Day
0.52009
Reported Licensed Staffing Hours per Resident per Day
1.42321
Reported Total Nurse Staffing Hours per Resident per Day
4.02501
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05045
Expected CNA Staffing Hours per Resident per Day
2.57392
Expected LPN Staffing Hours per Resident per Day
0.73143
Expected RN Staffing Hours per Resident per Day
1.22382
Expected Total Nurse Staffing Hours per Resident per Day
4.52917
Adjusted CNA Staffing Hours per Resident per Day
2.48027
Adjusted LPN Staffing Hours per Resident per Day
1.02483
Adjusted RN Staffing Hours per Resident per Day
0.31754
Adjusted Total Nurse Staffing Hours per Resident per Day
3.58220
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-07-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-04-23
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-01-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
14.00000
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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