Edgewood Manor Of Lucasville I - Lucasville Nursing Home
General Information
UPDATEFederal Provider Number
365585
Provider Name
EDGEWOOD MANOR OF LUCASVILLE I
Provider Address
10098 BIG BEAR CREEK RD
LUCASVILLE, OH 45648
LUCASVILLE, OH 45648
Provider Phone Number
(740) 259-5536
Provider SSA County
740
Provider County Name
Scioto
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
96
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUCASVILLE I FACILITY OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1982-08-16
Continuing Care Retirement Community
Y
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
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.01484
Reported LPN Staffing Hours per Resident per Day
0.69121
Reported RN Staffing Hours per Resident per Day
0.42857
Reported Licensed Staffing Hours per Resident per Day
1.11978
Reported Total Nurse Staffing Hours per Resident per Day
3.13462
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06264
Expected CNA Staffing Hours per Resident per Day
2.39815
Expected LPN Staffing Hours per Resident per Day
0.73264
Expected RN Staffing Hours per Resident per Day
1.23161
Expected Total Nurse Staffing Hours per Resident per Day
4.36240
Adjusted CNA Staffing Hours per Resident per Day
2.06151
Adjusted LPN Staffing Hours per Resident per Day
0.78306
Adjusted RN Staffing Hours per Resident per Day
0.26001
Adjusted Total Nurse Staffing Hours per Resident per Day
2.89642
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
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
32
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
16
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
16
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2011-07-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
31.33300
Number of Facility Reported Incidents
1
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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