Fairhaven Community - Upper Sandusky Nursing Home
General Information
UPDATEFederal Provider Number
365478
Provider Name
FAIRHAVEN COMMUNITY
Provider Address
850 S MARSEILLES AVENUE
UPPER SANDUSKY, OH 43351
UPPER SANDUSKY, OH 43351
Provider Phone Number
(419) 294-4973
Provider SSA County
890
Provider County Name
Wyandot
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
150
Number of Residents in Certified Beds
142
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UNITED CHURCH HOMES, INC.
Date First Approved to Provide Medicare and Medicaid services
1980-04-03
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.73873
Reported LPN Staffing Hours per Resident per Day
0.96092
Reported RN Staffing Hours per Resident per Day
0.50176
Reported Licensed Staffing Hours per Resident per Day
1.46268
Reported Total Nurse Staffing Hours per Resident per Day
4.20141
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03768
Expected CNA Staffing Hours per Resident per Day
2.42052
Expected LPN Staffing Hours per Resident per Day
0.71871
Expected RN Staffing Hours per Resident per Day
1.20458
Expected Total Nurse Staffing Hours per Resident per Day
4.34381
Adjusted CNA Staffing Hours per Resident per Day
2.77627
Adjusted LPN Staffing Hours per Resident per Day
1.10971
Adjusted RN Staffing Hours per Resident per Day
0.31124
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89876
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-06-19
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-04-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-12-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
17.33300
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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Nursiong Homes Nearby
Wyandot County Skilled Nursing And Rehabilitation
7830 N St Hwy 199 Rr2 |
UPPER SANDUSKY OH 43351 | 0.9 mile away