Crestview Manor, Inc - Dayton Nursing Home

General Information

UPDATE
Federal Provider Number
365497
Provider Name
CRESTVIEW MANOR, INC
Provider Address
4381 TONAWANDA TRAIL
DAYTON, OH 45430
Provider Phone Number
(937) 426-5033
Provider SSA County
580
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HCF OF CRESTVIEW, INC.
Date First Approved to Provide Medicare and Medicaid services
1980-06-05
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
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
2.12353
Reported LPN Staffing Hours per Resident per Day
0.75588
Reported RN Staffing Hours per Resident per Day
0.64191
Reported Licensed Staffing Hours per Resident per Day
1.39779
Reported Total Nurse Staffing Hours per Resident per Day
3.52132
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01250
Expected CNA Staffing Hours per Resident per Day
2.43234
Expected LPN Staffing Hours per Resident per Day
0.71022
Expected RN Staffing Hours per Resident per Day
1.25443
Expected Total Nurse Staffing Hours per Resident per Day
4.39698
Adjusted CNA Staffing Hours per Resident per Day
2.14218
Adjusted LPN Staffing Hours per Resident per Day
0.88336
Adjusted RN Staffing Hours per Resident per Day
0.38235
Adjusted Total Nurse Staffing Hours per Resident per Day
3.22814
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-01-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2012-10-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2011-06-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
42.00000
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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