Brown Memorial Home Inc - Circleville Nursing Home
General Information
UPDATEFederal Provider Number
366112
Provider Name
BROWN MEMORIAL HOME INC
Provider Address
158 E MOUND ST
CIRCLEVILLE, OH 43113
CIRCLEVILLE, OH 43113
Provider Phone Number
(740) 474-6238
Provider SSA County
660
Provider County Name
Pickaway
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
44
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BROWN MEMORIAL HOME, INC
Date First Approved to Provide Medicare and Medicaid services
1997-03-07
Continuing Care Retirement Community
Y
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
1
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
2.90769
Reported LPN Staffing Hours per Resident per Day
1.55000
Reported RN Staffing Hours per Resident per Day
1.11154
Reported Licensed Staffing Hours per Resident per Day
2.66154
Reported Total Nurse Staffing Hours per Resident per Day
5.56923
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10256
Expected CNA Staffing Hours per Resident per Day
2.63364
Expected LPN Staffing Hours per Resident per Day
0.65358
Expected RN Staffing Hours per Resident per Day
0.96890
Expected Total Nurse Staffing Hours per Resident per Day
4.25613
Adjusted CNA Staffing Hours per Resident per Day
2.70902
Adjusted LPN Staffing Hours per Resident per Day
1.96838
Adjusted RN Staffing Hours per Resident per Day
0.85720
Adjusted Total Nurse Staffing Hours per Resident per Day
5.27452
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
143
Cycle 1 Standard Survey Health Date
2015-03-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
143
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-08-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
81.50000
Number of Facility Reported Incidents
0
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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