Belle Manor Nursing Home - New Carlisle Nursing Home
General Information
UPDATEFederal Provider Number
365519
Provider Name
BELLE MANOR NURSING HOME
Provider Address
107 NORTH PIKE STREET
NEW CARLISLE, OH 45344
NEW CARLISLE, OH 45344
Provider Phone Number
(937) 845-3561
Provider SSA County
110
Provider County Name
Clark
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
53
Number of Residents in Certified Beds
36
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VANCREST OF NEW CARLISLE LLC
Date First Approved to Provide Medicare and Medicaid services
1980-06-23
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.57639
Reported LPN Staffing Hours per Resident per Day
1.19167
Reported RN Staffing Hours per Resident per Day
0.81944
Reported Licensed Staffing Hours per Resident per Day
2.01111
Reported Total Nurse Staffing Hours per Resident per Day
4.58750
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02361
Expected CNA Staffing Hours per Resident per Day
2.53019
Expected LPN Staffing Hours per Resident per Day
0.74228
Expected RN Staffing Hours per Resident per Day
1.24256
Expected Total Nurse Staffing Hours per Resident per Day
4.51503
Adjusted CNA Staffing Hours per Resident per Day
2.49851
Adjusted LPN Staffing Hours per Resident per Day
1.33250
Adjusted RN Staffing Hours per Resident per Day
0.49276
Adjusted Total Nurse Staffing Hours per Resident per Day
4.09560
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
2014-09-18
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-06-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
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
12
Cycle 3 Standard Health Survey Date
2012-03-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
18.00000
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
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