Colonial Nursing Center Of Rockford - Rockford Nursing Home
General Information
UPDATEFederal Provider Number
366234
Provider Name
COLONIAL NURSING CENTER OF ROCKFORD
Provider Address
201 BUCKEYE STREET
ROCKFORD, OH 45882
ROCKFORD, OH 45882
Provider Phone Number
(419) 363-2193
Provider SSA County
550
Provider County Name
Mercer
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
34
Number of Residents in Certified Beds
18
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COLONIAL HEALTHCARE LLC
Date First Approved to Provide Medicare and Medicaid services
2002-01-06
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
2.41111
Reported LPN Staffing Hours per Resident per Day
1.74722
Reported RN Staffing Hours per Resident per Day
0.63333
Reported Licensed Staffing Hours per Resident per Day
2.38056
Reported Total Nurse Staffing Hours per Resident per Day
4.79166
Reported Physical Therapist Staffing Hours per Resident Per Day
0.23889
Expected CNA Staffing Hours per Resident per Day
2.37639
Expected LPN Staffing Hours per Resident per Day
0.70775
Expected RN Staffing Hours per Resident per Day
1.15121
Expected Total Nurse Staffing Hours per Resident per Day
4.23536
Adjusted CNA Staffing Hours per Resident per Day
2.48955
Adjusted LPN Staffing Hours per Resident per Day
2.04901
Adjusted RN Staffing Hours per Resident per Day
0.41107
Adjusted Total Nurse Staffing Hours per Resident per Day
4.56035
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-09-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-06-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
28.66700
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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