Essex Of Salem Iii - Salem Nursing Home
General Information
UPDATEFederal Provider Number
366034
Provider Name
ESSEX OF SALEM III
Provider Address
230 CONTINENTAL DRIVE
SALEM, OH 44460
SALEM, OH 44460
Provider Phone Number
(330) 337-9503
Provider SSA County
140
Provider County Name
Columbiana
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ESSEX HEALTHCARE CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1995-12-01
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
3
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
2.46279
Reported LPN Staffing Hours per Resident per Day
1.07558
Reported RN Staffing Hours per Resident per Day
0.51163
Reported Licensed Staffing Hours per Resident per Day
1.58721
Reported Total Nurse Staffing Hours per Resident per Day
4.05000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07674
Expected CNA Staffing Hours per Resident per Day
2.62534
Expected LPN Staffing Hours per Resident per Day
0.82842
Expected RN Staffing Hours per Resident per Day
1.36138
Expected Total Nurse Staffing Hours per Resident per Day
4.81514
Adjusted CNA Staffing Hours per Resident per Day
2.30177
Adjusted LPN Staffing Hours per Resident per Day
1.07763
Adjusted RN Staffing Hours per Resident per Day
0.28081
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39038
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
16
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-11-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
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
12
Cycle 3 Standard Health Survey Date
2012-08-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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