Camelot Hall Convalescent Ctr - Livonia Nursing Home
General Information
UPDATEFederal Provider Number
235655
Provider Name
CAMELOT HALL CONVALESCENT CTR
Provider Address
35100 ANN ARBOR TRAIL
LIVONIA, MI 48150
LIVONIA, MI 48150
Provider Phone Number
(734) 522-1444
Provider SSA County
810
Provider County Name
Wayne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
122
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CAMELOT HALL ACQUISITION COMPANY INC
Date First Approved to Provide Medicare and Medicaid services
2012-06-22
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.74902
Reported LPN Staffing Hours per Resident per Day
0.74510
Reported RN Staffing Hours per Resident per Day
0.67206
Reported Licensed Staffing Hours per Resident per Day
1.41716
Reported Total Nurse Staffing Hours per Resident per Day
3.16618
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07794
Expected CNA Staffing Hours per Resident per Day
2.36809
Expected LPN Staffing Hours per Resident per Day
0.61863
Expected RN Staffing Hours per Resident per Day
1.00164
Expected Total Nurse Staffing Hours per Resident per Day
3.98837
Adjusted CNA Staffing Hours per Resident per Day
1.81225
Adjusted LPN Staffing Hours per Resident per Day
0.99967
Adjusted RN Staffing Hours per Resident per Day
0.50134
Adjusted Total Nurse Staffing Hours per Resident per Day
3.19994
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-09-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-07-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-06-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
54.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
7053
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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