Ohio Nursing Homes >> Sidney Nursing Homes >> Fair Haven Shelby County

Fair Haven Shelby County - Sidney Nursing Home

General Information

UPDATE
Federal Provider Number
366235
Provider Name
FAIR HAVEN SHELBY COUNTY
Provider Address
2901 FAIR ROAD
SIDNEY, OH 45365
Provider Phone Number
(937) 492-6900
Provider SSA County
760
Provider County Name
Shelby
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
134
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHELBY COUNTY OHIO
Date First Approved to Provide Medicare and Medicaid services
2002-03-02
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
4
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
1.91350
Reported LPN Staffing Hours per Resident per Day
1.39100
Reported RN Staffing Hours per Resident per Day
0.49500
Reported Licensed Staffing Hours per Resident per Day
1.88600
Reported Total Nurse Staffing Hours per Resident per Day
3.79950
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01950
Expected CNA Staffing Hours per Resident per Day
2.33908
Expected LPN Staffing Hours per Resident per Day
0.62271
Expected RN Staffing Hours per Resident per Day
0.97667
Expected Total Nurse Staffing Hours per Resident per Day
3.93846
Adjusted CNA Staffing Hours per Resident per Day
2.00727
Adjusted LPN Staffing Hours per Resident per Day
1.85403
Adjusted RN Staffing Hours per Resident per Day
0.37870
Adjusted Total Nurse Staffing Hours per Resident per Day
3.88868
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
2014-03-27
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-01-24
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-09-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
13.33300
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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