Boulevard Temple Care Center, Llc - Detroit Nursing Home
General Information
UPDATEFederal Provider Number
235498
Provider Name
BOULEVARD TEMPLE CARE CENTER, LLC
Provider Address
2567 WEST GRAND BOULEVARD
DETROIT, MI 48208
DETROIT, MI 48208
Provider Phone Number
(313) 895-5340
Provider SSA County
810
Provider County Name
Wayne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
124
Number of Residents in Certified Beds
116
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BOULEVARD TEMPLE CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1990-05-03
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.23017
Reported LPN Staffing Hours per Resident per Day
0.84526
Reported RN Staffing Hours per Resident per Day
0.72371
Reported Licensed Staffing Hours per Resident per Day
1.56897
Reported Total Nurse Staffing Hours per Resident per Day
3.79914
Reported Physical Therapist Staffing Hours per Resident Per Day
0.21164
Expected CNA Staffing Hours per Resident per Day
2.50183
Expected LPN Staffing Hours per Resident per Day
0.62801
Expected RN Staffing Hours per Resident per Day
1.01803
Expected Total Nurse Staffing Hours per Resident per Day
4.14787
Adjusted CNA Staffing Hours per Resident per Day
2.18726
Adjusted LPN Staffing Hours per Resident per Day
1.11713
Adjusted RN Staffing Hours per Resident per Day
0.53118
Adjusted Total Nurse Staffing Hours per Resident per Day
3.69200
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-02-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2014-03-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2013-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
45.33300
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
5070
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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