Edgewood Manor Of Lucasville Ii - Lucasville Nursing Home
General Information
UPDATEFederal Provider Number
365932
Provider Name
EDGEWOOD MANOR OF LUCASVILLE II
Provider Address
10098A BEAR CREEK ROAD
LUCASVILLE, OH 45648
LUCASVILLE, OH 45648
Provider Phone Number
(740) 259-2351
Provider SSA County
740
Provider County Name
Scioto
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
71
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUCASVILLE II FACILITY OPERATIONS
Date First Approved to Provide Medicare and Medicaid services
1993-09-02
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
4
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
2.52101
Reported LPN Staffing Hours per Resident per Day
0.53623
Reported RN Staffing Hours per Resident per Day
0.65362
Reported Licensed Staffing Hours per Resident per Day
1.18986
Reported Total Nurse Staffing Hours per Resident per Day
3.71086
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01739
Expected CNA Staffing Hours per Resident per Day
2.31350
Expected LPN Staffing Hours per Resident per Day
0.61377
Expected RN Staffing Hours per Resident per Day
1.02591
Expected Total Nurse Staffing Hours per Resident per Day
3.95318
Adjusted CNA Staffing Hours per Resident per Day
2.67378
Adjusted LPN Staffing Hours per Resident per Day
0.72514
Adjusted RN Staffing Hours per Resident per Day
0.47605
Adjusted Total Nurse Staffing Hours per Resident per Day
3.78381
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
8
Cycle 1 Standard Survey Health Date
2015-02-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-11-21
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-08-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
12.66700
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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