Good Shepherd Home - Fostoria Nursing Home
General Information
UPDATEFederal Provider Number
365963
Provider Name
GOOD SHEPHERD HOME
Provider Address
725 COLUMBUS AVE
FOSTORIA, OH 44830
FOSTORIA, OH 44830
Provider Phone Number
(419) 937-1801
Provider SSA County
750
Provider County Name
Seneca
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
112
Number of Residents in Certified Beds
111
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SHEPHERD HOME
Date First Approved to Provide Medicare and Medicaid services
1994-04-18
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
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
2.46351
Reported LPN Staffing Hours per Resident per Day
0.48108
Reported RN Staffing Hours per Resident per Day
0.66802
Reported Licensed Staffing Hours per Resident per Day
1.14910
Reported Total Nurse Staffing Hours per Resident per Day
3.61261
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05811
Expected CNA Staffing Hours per Resident per Day
2.66572
Expected LPN Staffing Hours per Resident per Day
0.61365
Expected RN Staffing Hours per Resident per Day
0.91832
Expected Total Nurse Staffing Hours per Resident per Day
4.19769
Adjusted CNA Staffing Hours per Resident per Day
2.26757
Adjusted LPN Staffing Hours per Resident per Day
0.65069
Adjusted RN Staffing Hours per Resident per Day
0.54354
Adjusted Total Nurse Staffing Hours per Resident per Day
3.46906
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-06-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
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
2012-03-29
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
19.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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