Fairmount Health Center - Willoughby Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
365581
Provider Name
FAIRMOUNT HEALTH CENTER
Provider Address
36855 RIDGE RD
WILLOUGHBY, OH 44094
WILLOUGHBY, OH 44094
Provider Phone Number
(440) 942-4342
Provider SSA County
440
Provider County Name
Lake
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
108
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
OPRS COMMUNITIES
Date First Approved to Provide Medicare and Medicaid services
1982-06-11
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
2
Health Inspection Rating Footnote
QM Rating
5
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
3.19792
Reported LPN Staffing Hours per Resident per Day
1.28438
Reported RN Staffing Hours per Resident per Day
0.60625
Reported Licensed Staffing Hours per Resident per Day
1.89063
Reported Total Nurse Staffing Hours per Resident per Day
5.08855
Reported Physical Therapist Staffing Hours per Resident Per Day
0.23958
Expected CNA Staffing Hours per Resident per Day
2.57080
Expected LPN Staffing Hours per Resident per Day
0.68930
Expected RN Staffing Hours per Resident per Day
1.22377
Expected Total Nurse Staffing Hours per Resident per Day
4.48387
Adjusted CNA Staffing Hours per Resident per Day
3.05225
Adjusted LPN Staffing Hours per Resident per Day
1.54656
Adjusted RN Staffing Hours per Resident per Day
0.37016
Adjusted Total Nurse Staffing Hours per Resident per Day
4.57449
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
79
Cycle 2 Standard Health Survey Date
2013-07-25
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
79
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-04-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
31.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
143390
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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