Country Court - Mount Vernon Nursing Home

General Information

UPDATE
Federal Provider Number
365269
Provider Name
COUNTRY COURT
Provider Address
1076 COSHOCTON AVE
MOUNT VERNON, OH 43050
Provider Phone Number
(740) 397-4125
Provider SSA County
430
Provider County Name
Knox
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
92
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LEVERING MANAGEMENT, INC.
Date First Approved to Provide Medicare and Medicaid services
1971-08-17
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
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.41154
Reported LPN Staffing Hours per Resident per Day
0.80077
Reported RN Staffing Hours per Resident per Day
1.11000
Reported Licensed Staffing Hours per Resident per Day
1.91077
Reported Total Nurse Staffing Hours per Resident per Day
4.32231
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08769
Expected CNA Staffing Hours per Resident per Day
2.40759
Expected LPN Staffing Hours per Resident per Day
0.77603
Expected RN Staffing Hours per Resident per Day
1.20634
Expected Total Nurse Staffing Hours per Resident per Day
4.38996
Adjusted CNA Staffing Hours per Resident per Day
2.45772
Adjusted LPN Staffing Hours per Resident per Day
0.85646
Adjusted RN Staffing Hours per Resident per Day
0.68753
Adjusted Total Nurse Staffing Hours per Resident per Day
3.96878
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-03-12
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-12-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-09-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
19.33300
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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