Ohio Nursing Homes >> Monclova Nursing Homes >> Avalon By Otterbein Monclova

Avalon By Otterbein Monclova - Monclova Nursing Home

General Information

UPDATE
Federal Provider Number
366361
Provider Name
AVALON BY OTTERBEIN MONCLOVA
Provider Address
5069 OTTERBEIN WAY
MONCLOVA, OH 43542
Provider Phone Number
(419) 878-0550
Provider SSA County
490
Provider County Name
Lucas
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2008-05-20
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
2
QM Rating Footnote
Staffing Rating
3
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
4.07609
Reported LPN Staffing Hours per Resident per Day
0.80761
Reported RN Staffing Hours per Resident per Day
0.56848
Reported Licensed Staffing Hours per Resident per Day
1.37609
Reported Total Nurse Staffing Hours per Resident per Day
5.45218
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04783
Expected CNA Staffing Hours per Resident per Day
2.42676
Expected LPN Staffing Hours per Resident per Day
0.69117
Expected RN Staffing Hours per Resident per Day
1.32781
Expected Total Nurse Staffing Hours per Resident per Day
4.44574
Adjusted CNA Staffing Hours per Resident per Day
4.12134
Adjusted LPN Staffing Hours per Resident per Day
0.96983
Adjusted RN Staffing Hours per Resident per Day
0.31990
Adjusted Total Nurse Staffing Hours per Resident per Day
4.94342
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
87
Cycle 1 Standard Survey Health Date
2014-04-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
87
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-01-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
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
12
Cycle 3 Standard Health Survey Date
2011-09-22
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
6
Cycle 3 Total Health Score
18
Total Weighted Health Survey Score
61.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
Number of Fines
3
Total Amount of Fines in Dollars
33513
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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