Cypress Pointe Health Campus - Englewood Nursing Home

General Information

UPDATE
Federal Provider Number
366384
Provider Name
CYPRESS POINTE HEALTH CAMPUS
Provider Address
600 WEST NATIONAL ROAD
ENGLEWOOD, OH 45322
Provider Phone Number
(937) 836-3149
Provider SSA County
580
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
79
Number of Residents in Certified Beds
72
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRILOGY HEALTHCARE OF MONTGOMERY LLC
Date First Approved to Provide Medicare and Medicaid services
2010-02-25
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
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
2.51597
Reported LPN Staffing Hours per Resident per Day
1.46042
Reported RN Staffing Hours per Resident per Day
0.71528
Reported Licensed Staffing Hours per Resident per Day
2.17569
Reported Total Nurse Staffing Hours per Resident per Day
4.69167
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07917
Expected CNA Staffing Hours per Resident per Day
2.49704
Expected LPN Staffing Hours per Resident per Day
0.71009
Expected RN Staffing Hours per Resident per Day
1.34142
Expected Total Nurse Staffing Hours per Resident per Day
4.54855
Adjusted CNA Staffing Hours per Resident per Day
2.47230
Adjusted LPN Staffing Hours per Resident per Day
1.70703
Adjusted RN Staffing Hours per Resident per Day
0.39843
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15773
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
15.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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