Genoa Retirement Village - Genoa Nursing Home
General Information
UPDATEFederal Provider Number
365663
Provider Name
GENOA RETIREMENT VILLAGE
Provider Address
300 CHERRY ST
GENOA, OH 43430
GENOA, OH 43430
Provider Phone Number
(419) 855-7755
Provider SSA County
630
Provider County Name
Ottawa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRILOGY HEALTHCARE OF OTTAWA, LLC
Date First Approved to Provide Medicare and Medicaid services
1985-06-25
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.15588
Reported LPN Staffing Hours per Resident per Day
0.68382
Reported RN Staffing Hours per Resident per Day
0.88235
Reported Licensed Staffing Hours per Resident per Day
1.56618
Reported Total Nurse Staffing Hours per Resident per Day
3.72205
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01176
Expected CNA Staffing Hours per Resident per Day
2.51273
Expected LPN Staffing Hours per Resident per Day
0.68224
Expected RN Staffing Hours per Resident per Day
1.20812
Expected Total Nurse Staffing Hours per Resident per Day
4.40309
Adjusted CNA Staffing Hours per Resident per Day
2.10523
Adjusted LPN Staffing Hours per Resident per Day
0.83192
Adjusted RN Staffing Hours per Resident per Day
0.54572
Adjusted Total Nurse Staffing Hours per Resident per Day
3.40743
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
2014-05-29
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
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
2013-03-14
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2011-11-17
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
8.00000
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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