Blossom Nursing And Rehab Center - Salem Nursing Home
General Information
UPDATEFederal Provider Number
366169
Provider Name
BLOSSOM NURSING AND REHAB CENTER
Provider Address
109 BLOSSOM LANE
SALEM, OH 44460
SALEM, OH 44460
Provider Phone Number
(330) 337-3033
Provider SSA County
140
Provider County Name
Columbiana
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ORION BLOSSOM LLC
Date First Approved to Provide Medicare and Medicaid services
1998-11-24
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
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
2.68878
Reported LPN Staffing Hours per Resident per Day
0.88878
Reported RN Staffing Hours per Resident per Day
0.57857
Reported Licensed Staffing Hours per Resident per Day
1.46735
Reported Total Nurse Staffing Hours per Resident per Day
4.15613
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06122
Expected CNA Staffing Hours per Resident per Day
2.51668
Expected LPN Staffing Hours per Resident per Day
0.70839
Expected RN Staffing Hours per Resident per Day
1.26915
Expected Total Nurse Staffing Hours per Resident per Day
4.49422
Adjusted CNA Staffing Hours per Resident per Day
2.62150
Adjusted LPN Staffing Hours per Resident per Day
1.04135
Adjusted RN Staffing Hours per Resident per Day
0.34063
Adjusted Total Nurse Staffing Hours per Resident per Day
3.72766
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-02-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2012-11-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2011-08-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
16640
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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