Amberwood Manor - New Philadelphia Nursing Home
General Information
UPDATEFederal Provider Number
366253
Provider Name
AMBERWOOD MANOR
Provider Address
245 SOUTH BROADWAY
NEW PHILADELPHIA, OH 44663
NEW PHILADELPHIA, OH 44663
Provider Phone Number
(330) 339-2151
Provider SSA County
800
Provider County Name
Tuscarawas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
49
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOUTH BROADWAY HEALTHCARE GROUP, INC
Date First Approved to Provide Medicare and Medicaid services
2002-12-31
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.01220
Reported LPN Staffing Hours per Resident per Day
0.75610
Reported RN Staffing Hours per Resident per Day
0.76951
Reported Licensed Staffing Hours per Resident per Day
1.52561
Reported Total Nurse Staffing Hours per Resident per Day
3.53781
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01707
Expected CNA Staffing Hours per Resident per Day
2.62076
Expected LPN Staffing Hours per Resident per Day
0.83517
Expected RN Staffing Hours per Resident per Day
1.40912
Expected Total Nurse Staffing Hours per Resident per Day
4.86506
Adjusted CNA Staffing Hours per Resident per Day
1.88393
Adjusted LPN Staffing Hours per Resident per Day
0.75142
Adjusted RN Staffing Hours per Resident per Day
0.40804
Adjusted Total Nurse Staffing Hours per Resident per Day
2.93122
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
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
2012-02-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
54.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
2080
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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