Avalon By Otterbein At Maineville - Maineville Nursing Home

General Information

UPDATE
Federal Provider Number
366393
Provider Name
AVALON BY OTTERBEIN AT MAINEVILLE
Provider Address
201 MARGE SCHOTT WAY
MAINEVILLE, OH 45039
Provider Phone Number
5133095650
Provider SSA County
840
Provider County Name
Warren
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
OTTERBEIN MAINEVILLE, LLC
Date First Approved to Provide Medicare and Medicaid services
2010-10-07
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
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
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
4.36122
Reported LPN Staffing Hours per Resident per Day
0.64796
Reported RN Staffing Hours per Resident per Day
0.74286
Reported Licensed Staffing Hours per Resident per Day
1.39082
Reported Total Nurse Staffing Hours per Resident per Day
5.75204
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10612
Expected CNA Staffing Hours per Resident per Day
2.32580
Expected LPN Staffing Hours per Resident per Day
0.67512
Expected RN Staffing Hours per Resident per Day
1.15485
Expected Total Nurse Staffing Hours per Resident per Day
4.15577
Adjusted CNA Staffing Hours per Resident per Day
4.60106
Adjusted LPN Staffing Hours per Resident per Day
0.79660
Adjusted RN Staffing Hours per Resident per Day
0.48064
Adjusted Total Nurse Staffing Hours per Resident per Day
5.57920
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
8
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
8
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-04-18
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-01-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
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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