Otterbein St Marys Retirement Community - St Marys Nursing Home
General Information
UPDATEFederal Provider Number
365953
Provider Name
OTTERBEIN ST MARYS RETIREMENT COMMUNITY
Provider Address
11230 STATE ROUTE 364
ST MARYS, OH 45885
ST MARYS, OH 45885
Provider Phone Number
4193946330
Provider SSA County
50
Provider County Name
Auglaize
Ownership Type
Non profit - Church related
Number of Certified Beds
45
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
OTTERBEIN SAINT MARYS
Date First Approved to Provide Medicare and Medicaid services
1994-02-09
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.58372
Reported LPN Staffing Hours per Resident per Day
0.52442
Reported RN Staffing Hours per Resident per Day
0.82093
Reported Licensed Staffing Hours per Resident per Day
1.34535
Reported Total Nurse Staffing Hours per Resident per Day
3.92907
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01279
Expected CNA Staffing Hours per Resident per Day
2.66819
Expected LPN Staffing Hours per Resident per Day
0.62356
Expected RN Staffing Hours per Resident per Day
1.02351
Expected Total Nurse Staffing Hours per Resident per Day
4.31525
Adjusted CNA Staffing Hours per Resident per Day
2.37602
Adjusted LPN Staffing Hours per Resident per Day
0.69804
Adjusted RN Staffing Hours per Resident per Day
0.59931
Adjusted Total Nurse Staffing Hours per Resident per Day
3.67016
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-03-21
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2011-11-30
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
12.00000
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
Nursiong Homes Nearby
St Marys Living Center
1209 Indiana Avenue |
ST MARYS OH 45885 | 2.7 miles away
Vancrest Of St Mary's
1140 Knoxville Road |
ST MARYS OH 45885 | 3.5 miles away
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