Clark Retirement Community - Grand Rapids Nursing Home
General Information
UPDATEFederal Provider Number
235401
Provider Name
CLARK RETIREMENT COMMUNITY
Provider Address
1551 FRANKLIN STREET, SE
GRAND RAPIDS, MI 49506
GRAND RAPIDS, MI 49506
Provider Phone Number
(616) 452-1568
Provider SSA County
400
Provider County Name
Kent
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
111
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLARK RETIREMENT COMMUNITY INC.
Date First Approved to Provide Medicare and Medicaid services
1979-10-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
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
3.32421
Reported LPN Staffing Hours per Resident per Day
0.53737
Reported RN Staffing Hours per Resident per Day
1.41947
Reported Licensed Staffing Hours per Resident per Day
1.95684
Reported Total Nurse Staffing Hours per Resident per Day
5.28105
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17316
Expected CNA Staffing Hours per Resident per Day
2.76100
Expected LPN Staffing Hours per Resident per Day
0.60083
Expected RN Staffing Hours per Resident per Day
0.90998
Expected Total Nurse Staffing Hours per Resident per Day
4.27181
Adjusted CNA Staffing Hours per Resident per Day
2.95423
Adjusted LPN Staffing Hours per Resident per Day
0.74234
Adjusted RN Staffing Hours per Resident per Day
1.16555
Adjusted Total Nurse Staffing Hours per Resident per Day
4.98322
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
179
Cycle 1 Standard Survey Health Date
2015-03-05
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
179
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2014-02-27
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
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2013-02-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
114.83300
Number of Facility Reported Incidents
7
Number of Substantiated Complaints
7
Number of Fines
2
Total Amount of Fines in Dollars
21795
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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