Fairview Skilled Nursing And R - Toledo Nursing Home
General Information
UPDATEFederal Provider Number
365488
Provider Name
FAIRVIEW SKILLED NURSING AND R
Provider Address
4420 SOUTH AVENUE
TOLEDO, OH 43615
TOLEDO, OH 43615
Provider Phone Number
(419) 531-4201
Provider SSA County
490
Provider County Name
Lucas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
108
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE OHIO, INC.
Date First Approved to Provide Medicare and Medicaid services
1980-05-09
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
3
Health Inspection Rating Footnote
QM Rating
4
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
2.58462
Reported LPN Staffing Hours per Resident per Day
1.33154
Reported RN Staffing Hours per Resident per Day
1.26077
Reported Licensed Staffing Hours per Resident per Day
2.59231
Reported Total Nurse Staffing Hours per Resident per Day
5.17693
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02538
Expected CNA Staffing Hours per Resident per Day
2.46864
Expected LPN Staffing Hours per Resident per Day
0.69897
Expected RN Staffing Hours per Resident per Day
1.20584
Expected Total Nurse Staffing Hours per Resident per Day
4.37345
Adjusted CNA Staffing Hours per Resident per Day
2.56898
Adjusted LPN Staffing Hours per Resident per Day
1.58115
Adjusted RN Staffing Hours per Resident per Day
0.78124
Adjusted Total Nurse Staffing Hours per Resident per Day
4.77145
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-02-25
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
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-12-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
23.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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