Belmont Manor - St Clairsville Nursing Home
General Information
UPDATEFederal Provider Number
366190
Provider Name
BELMONT MANOR
Provider Address
51999 GUIRINO DRIVE
ST CLAIRSVILLE, OH 43950
ST CLAIRSVILLE, OH 43950
Provider Phone Number
(740) 695-4404
Provider SSA County
60
Provider County Name
Belmont
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BELMONT MANOR INC.
Date First Approved to Provide Medicare and Medicaid services
2000-02-09
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
3
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
2.72021
Reported LPN Staffing Hours per Resident per Day
0.53936
Reported RN Staffing Hours per Resident per Day
0.69468
Reported Licensed Staffing Hours per Resident per Day
1.23404
Reported Total Nurse Staffing Hours per Resident per Day
3.95425
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05638
Expected CNA Staffing Hours per Resident per Day
2.42887
Expected LPN Staffing Hours per Resident per Day
0.65497
Expected RN Staffing Hours per Resident per Day
1.09639
Expected Total Nurse Staffing Hours per Resident per Day
4.18023
Adjusted CNA Staffing Hours per Resident per Day
2.74802
Adjusted LPN Staffing Hours per Resident per Day
0.68350
Adjusted RN Staffing Hours per Resident per Day
0.47343
Adjusted Total Nurse Staffing Hours per Resident per Day
3.81299
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-06-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-03-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2011-12-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
73.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
1625
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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