First Community Village Healthcare Ctr - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
365047
Provider Name
FIRST COMMUNITY VILLAGE HEALTHCARE CTR
Provider Address
1800 RIVERSIDE DRIVE
COLUMBUS, OH 43212
COLUMBUS, OH 43212
Provider Phone Number
(614) 486-9511
Provider SSA County
250
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
150
Number of Residents in Certified Beds
134
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FIRST COMMUNITY VILLAGE
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
4
QM Rating Footnote
Staffing Rating
3
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
2.23769
Reported LPN Staffing Hours per Resident per Day
0.50112
Reported RN Staffing Hours per Resident per Day
1.35896
Reported Licensed Staffing Hours per Resident per Day
1.86007
Reported Total Nurse Staffing Hours per Resident per Day
4.09777
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08209
Expected CNA Staffing Hours per Resident per Day
2.57801
Expected LPN Staffing Hours per Resident per Day
0.75541
Expected RN Staffing Hours per Resident per Day
1.29579
Expected Total Nurse Staffing Hours per Resident per Day
4.62921
Adjusted CNA Staffing Hours per Resident per Day
2.12979
Adjusted LPN Staffing Hours per Resident per Day
0.55060
Adjusted RN Staffing Hours per Resident per Day
0.78363
Adjusted Total Nurse Staffing Hours per Resident per Day
3.56815
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-08-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
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
2013-05-31
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
5
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-02-24
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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