Eliza Jennings Home - Cleveland Nursing Home
General Information
UPDATEFederal Provider Number
366079
Provider Name
ELIZA JENNINGS HOME
Provider Address
10603 DETROIT AVENUE
CLEVELAND, OH 44102
CLEVELAND, OH 44102
Provider Phone Number
2162260282
Provider SSA County
170
Provider County Name
Cuyahoga
Ownership Type
Non profit - Corporation
Number of Certified Beds
136
Number of Residents in Certified Beds
118
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ELIZA JENNINGS HOME
Date First Approved to Provide Medicare and Medicaid services
1996-07-10
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
4
Overall Rating Footnote
Health Inspection Rating
4
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
2.43051
Reported LPN Staffing Hours per Resident per Day
0.78093
Reported RN Staffing Hours per Resident per Day
0.85297
Reported Licensed Staffing Hours per Resident per Day
1.63390
Reported Total Nurse Staffing Hours per Resident per Day
4.06441
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05805
Expected CNA Staffing Hours per Resident per Day
2.45157
Expected LPN Staffing Hours per Resident per Day
0.69442
Expected RN Staffing Hours per Resident per Day
1.20604
Expected Total Nurse Staffing Hours per Resident per Day
4.35202
Adjusted CNA Staffing Hours per Resident per Day
2.43262
Adjusted LPN Staffing Hours per Resident per Day
0.93340
Adjusted RN Staffing Hours per Resident per Day
0.52846
Adjusted Total Nurse Staffing Hours per Resident per Day
3.76451
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-08
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-02-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-10-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
16.00000
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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