Evangelical Home - Saline - Saline Nursing Home
General Information
UPDATEFederal Provider Number
235238
Provider Name
EVANGELICAL HOME - SALINE
Provider Address
440 W RUSSELL
SALINE, MI 48176
SALINE, MI 48176
Provider Phone Number
7344299401
Provider SSA County
800
Provider County Name
Washtenaw
Ownership Type
Non profit - Corporation
Number of Certified Beds
215
Number of Residents in Certified Beds
198
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVANGELICAL HOMES OF MICHIGAN
Date First Approved to Provide Medicare and Medicaid services
1975-01-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.08712
Reported LPN Staffing Hours per Resident per Day
0.85581
Reported RN Staffing Hours per Resident per Day
1.33081
Reported Licensed Staffing Hours per Resident per Day
2.18662
Reported Total Nurse Staffing Hours per Resident per Day
5.27374
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07803
Expected CNA Staffing Hours per Resident per Day
2.41063
Expected LPN Staffing Hours per Resident per Day
0.61316
Expected RN Staffing Hours per Resident per Day
1.00507
Expected Total Nurse Staffing Hours per Resident per Day
4.02885
Adjusted CNA Staffing Hours per Resident per Day
3.14228
Adjusted LPN Staffing Hours per Resident per Day
1.15847
Adjusted RN Staffing Hours per Resident per Day
0.98937
Adjusted Total Nurse Staffing Hours per Resident per Day
5.27642
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-03-07
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
14
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2013-02-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
48.00000
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
6500
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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