Convalarium At Indian Run The - Dublin Nursing Home
General Information
UPDATEFederal Provider Number
365717
Provider Name
CONVALARIUM AT INDIAN RUN THE
Provider Address
6430 POST RD
DUBLIN, OH 43016
DUBLIN, OH 43016
Provider Phone Number
(614) 761-1188
Provider SSA County
250
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEALTHCARE VENTURES OF OHIO LLC
Date First Approved to Provide Medicare and Medicaid services
1988-12-16
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.08133
Reported LPN Staffing Hours per Resident per Day
1.01467
Reported RN Staffing Hours per Resident per Day
0.84467
Reported Licensed Staffing Hours per Resident per Day
1.85933
Reported Total Nurse Staffing Hours per Resident per Day
3.94067
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16933
Expected CNA Staffing Hours per Resident per Day
2.46295
Expected LPN Staffing Hours per Resident per Day
0.74029
Expected RN Staffing Hours per Resident per Day
1.29738
Expected Total Nurse Staffing Hours per Resident per Day
4.50062
Adjusted CNA Staffing Hours per Resident per Day
2.07351
Adjusted LPN Staffing Hours per Resident per Day
1.13763
Adjusted RN Staffing Hours per Resident per Day
0.48647
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52939
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2012-11-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2011-08-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
41.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
11
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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