Clovernook Health Care Pavilion - Cincinnati Nursing Home
General Information
UPDATEFederal Provider Number
365551
Provider Name
CLOVERNOOK HEALTH CARE PAVILION
Provider Address
7025 CLOVERNOOK AVENUE
CINCINNATI, OH 45231
CINCINNATI, OH 45231
Provider Phone Number
(513) 605-4000
Provider SSA County
310
Provider County Name
Hamilton
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
119
Number of Residents in Certified Beds
114
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MICAH CLOVERNOOK
Date First Approved to Provide Medicare and Medicaid services
1981-03-18
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
2.43421
Reported LPN Staffing Hours per Resident per Day
0.78947
Reported RN Staffing Hours per Resident per Day
0.59211
Reported Licensed Staffing Hours per Resident per Day
1.38158
Reported Total Nurse Staffing Hours per Resident per Day
3.81579
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04342
Expected CNA Staffing Hours per Resident per Day
2.55847
Expected LPN Staffing Hours per Resident per Day
0.75956
Expected RN Staffing Hours per Resident per Day
1.26664
Expected Total Nurse Staffing Hours per Resident per Day
4.58466
Adjusted CNA Staffing Hours per Resident per Day
2.33453
Adjusted LPN Staffing Hours per Resident per Day
0.86269
Adjusted RN Staffing Hours per Resident per Day
0.34929
Adjusted Total Nurse Staffing Hours per Resident per Day
3.35490
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-04-16
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-09-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
10.00000
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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