Gardens At St Henry - Saint Henry Nursing Home
General Information
UPDATEFederal Provider Number
366197
Provider Name
GARDENS AT ST HENRY
Provider Address
522 WESTERN AVENUE
SAINT HENRY, OH 45883
SAINT HENRY, OH 45883
Provider Phone Number
(419) 678-9800
Provider SSA County
550
Provider County Name
Mercer
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
24
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEALTHCARE VENTURES OF OHIO LLC
Date First Approved to Provide Medicare and Medicaid services
2000-05-10
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.02708
Reported LPN Staffing Hours per Resident per Day
0.57708
Reported RN Staffing Hours per Resident per Day
1.07292
Reported Licensed Staffing Hours per Resident per Day
1.65000
Reported Total Nurse Staffing Hours per Resident per Day
3.67708
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03542
Expected CNA Staffing Hours per Resident per Day
2.59366
Expected LPN Staffing Hours per Resident per Day
0.66356
Expected RN Staffing Hours per Resident per Day
1.20678
Expected Total Nurse Staffing Hours per Resident per Day
4.46400
Adjusted CNA Staffing Hours per Resident per Day
1.91769
Adjusted LPN Staffing Hours per Resident per Day
0.72183
Adjusted RN Staffing Hours per Resident per Day
0.66432
Adjusted Total Nurse Staffing Hours per Resident per Day
3.32033
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-02-19
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-04-24
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
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2013-01-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
14.00000
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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