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Friendship Village Health Center - Columbus Nursing Home

General Information

UPDATE
Federal Provider Number
365399
Provider Name
FRIENDSHIP VILLAGE HEALTH CENTER
Provider Address
5757 PONDEROSA DRIVE
COLUMBUS, OH 43231
Provider Phone Number
6148908282
Provider SSA County
250
Provider County Name
Franklin
Ownership Type
Non profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FRIENDSHIP VILLAGE OF COLUMBUS
Date First Approved to Provide Medicare and Medicaid services
1978-11-03
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
2
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
2.63615
Reported LPN Staffing Hours per Resident per Day
0.89615
Reported RN Staffing Hours per Resident per Day
0.81769
Reported Licensed Staffing Hours per Resident per Day
1.71385
Reported Total Nurse Staffing Hours per Resident per Day
4.34999
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16846
Expected CNA Staffing Hours per Resident per Day
2.61695
Expected LPN Staffing Hours per Resident per Day
0.71710
Expected RN Staffing Hours per Resident per Day
1.22938
Expected Total Nurse Staffing Hours per Resident per Day
4.56343
Adjusted CNA Staffing Hours per Resident per Day
2.47171
Adjusted LPN Staffing Hours per Resident per Day
1.03724
Adjusted RN Staffing Hours per Resident per Day
0.49698
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84237
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-01-09
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2012-10-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2011-07-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
28.66700
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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