Adams County Manor - West Union Nursing Home
General Information
UPDATEFederal Provider Number
366143
Provider Name
ADAMS COUNTY MANOR
Provider Address
10856 STATE ROUTE 41
WEST UNION, OH 45693
WEST UNION, OH 45693
Provider Phone Number
(937) 544-2205
Provider SSA County
0
Provider County Name
Adams
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
74
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
H&G NURSING HOMES, INC
Date First Approved to Provide Medicare and Medicaid services
1997-08-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
2.62571
Reported LPN Staffing Hours per Resident per Day
0.85929
Reported RN Staffing Hours per Resident per Day
0.93786
Reported Licensed Staffing Hours per Resident per Day
1.79714
Reported Total Nurse Staffing Hours per Resident per Day
4.42286
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08571
Expected CNA Staffing Hours per Resident per Day
2.65283
Expected LPN Staffing Hours per Resident per Day
0.77457
Expected RN Staffing Hours per Resident per Day
1.36646
Expected Total Nurse Staffing Hours per Resident per Day
4.79386
Adjusted CNA Staffing Hours per Resident per Day
2.42861
Adjusted LPN Staffing Hours per Resident per Day
0.92078
Adjusted RN Staffing Hours per Resident per Day
0.51284
Adjusted Total Nurse Staffing Hours per Resident per Day
3.71895
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-07-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
2013-04-11
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-01-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
11.33300
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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