Bortz Health Care Of Petoskey - Petoskey Nursing Home
General Information
UPDATEFederal Provider Number
235429
Provider Name
BORTZ HEALTH CARE OF PETOSKEY
Provider Address
1500 SPRING ST
PETOSKEY, MI 49770
PETOSKEY, MI 49770
Provider Phone Number
(231) 347-5500
Provider SSA County
230
Provider County Name
Emmet
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
110
Number of Residents in Certified Beds
89
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETOSKEY GERIATRIC VILLAGE, INC
Date First Approved to Provide Medicare and Medicaid services
1983-03-25
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.08202
Reported LPN Staffing Hours per Resident per Day
0.60056
Reported RN Staffing Hours per Resident per Day
0.92247
Reported Licensed Staffing Hours per Resident per Day
1.52303
Reported Total Nurse Staffing Hours per Resident per Day
4.60505
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09607
Expected CNA Staffing Hours per Resident per Day
2.25834
Expected LPN Staffing Hours per Resident per Day
0.56535
Expected RN Staffing Hours per Resident per Day
0.86544
Expected Total Nurse Staffing Hours per Resident per Day
3.68913
Adjusted CNA Staffing Hours per Resident per Day
3.34863
Adjusted LPN Staffing Hours per Resident per Day
0.88169
Adjusted RN Staffing Hours per Resident per Day
0.79644
Adjusted Total Nurse Staffing Hours per Resident per Day
5.03167
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-02-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-02-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
1
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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