Brookhaven Nursing & Rehabilitation Center - Brookville Nursing Home
General Information
UPDATEFederal Provider Number
365422
Provider Name
BROOKHAVEN NURSING & REHABILITATION CENTER
Provider Address
ONE COUNTRY LANE
BROOKVILLE, OH 45309
BROOKVILLE, OH 45309
Provider Phone Number
9378332133
Provider SSA County
580
Provider County Name
Montgomery
Ownership Type
For profit - Corporation
Number of Certified Beds
140
Number of Residents in Certified Beds
112
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BROOKVILLE ENTERPRISE INC.
Date First Approved to Provide Medicare and Medicaid services
1979-10-02
Continuing Care Retirement Community
Y
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
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.67768
Reported LPN Staffing Hours per Resident per Day
1.30357
Reported RN Staffing Hours per Resident per Day
0.60536
Reported Licensed Staffing Hours per Resident per Day
1.90893
Reported Total Nurse Staffing Hours per Resident per Day
4.58661
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05045
Expected CNA Staffing Hours per Resident per Day
2.51029
Expected LPN Staffing Hours per Resident per Day
0.69324
Expected RN Staffing Hours per Resident per Day
1.26575
Expected Total Nurse Staffing Hours per Resident per Day
4.46928
Adjusted CNA Staffing Hours per Resident per Day
2.61731
Adjusted LPN Staffing Hours per Resident per Day
1.56073
Adjusted RN Staffing Hours per Resident per Day
0.35736
Adjusted Total Nurse Staffing Hours per Resident per Day
4.13672
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-12-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-09-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-06-11
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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