Gillette Nursing Home - Warren Nursing Home
General Information
UPDATEFederal Provider Number
366129
Provider Name
GILLETTE NURSING HOME
Provider Address
3310 ELM RD
WARREN, OH 44483
WARREN, OH 44483
Provider Phone Number
3303721960
Provider SSA County
790
Provider County Name
Trumbull
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GILLETTE NURSING HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1997-07-01
Continuing Care Retirement Community
N
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.50211
Reported LPN Staffing Hours per Resident per Day
1.28737
Reported RN Staffing Hours per Resident per Day
0.46368
Reported Licensed Staffing Hours per Resident per Day
1.75105
Reported Total Nurse Staffing Hours per Resident per Day
4.25316
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04526
Expected CNA Staffing Hours per Resident per Day
2.41817
Expected LPN Staffing Hours per Resident per Day
0.69868
Expected RN Staffing Hours per Resident per Day
1.15451
Expected Total Nurse Staffing Hours per Resident per Day
4.27136
Adjusted CNA Staffing Hours per Resident per Day
2.53887
Adjusted LPN Staffing Hours per Resident per Day
1.52934
Adjusted RN Staffing Hours per Resident per Day
0.30009
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01373
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-09-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
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
52
Cycle 2 Standard Health Survey Date
2013-06-14
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
15
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
104
Cycle 3 Standard Health Survey Date
2012-04-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
104
Total Weighted Health Survey Score
56.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
7150
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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