Good Shepherd Village - Springfield Nursing Home
General Information
UPDATEFederal Provider Number
366236
Provider Name
GOOD SHEPHERD VILLAGE
Provider Address
422 NORTH BURNETT ROAD
SPRINGFIELD, OH 45503
SPRINGFIELD, OH 45503
Provider Phone Number
9373221911
Provider SSA County
110
Provider County Name
Clark
Ownership Type
For profit - Individual
Number of Certified Beds
81
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SHEPHERD VILLAGE LLC
Date First Approved to Provide Medicare and Medicaid services
2002-04-06
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
1.66234
Reported LPN Staffing Hours per Resident per Day
0.24481
Reported RN Staffing Hours per Resident per Day
0.52662
Reported Licensed Staffing Hours per Resident per Day
0.77143
Reported Total Nurse Staffing Hours per Resident per Day
2.43377
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02987
Expected CNA Staffing Hours per Resident per Day
2.52625
Expected LPN Staffing Hours per Resident per Day
0.57919
Expected RN Staffing Hours per Resident per Day
0.81383
Expected Total Nurse Staffing Hours per Resident per Day
3.91927
Adjusted CNA Staffing Hours per Resident per Day
1.61460
Adjusted LPN Staffing Hours per Resident per Day
0.35082
Adjusted RN Staffing Hours per Resident per Day
0.48350
Adjusted Total Nurse Staffing Hours per Resident per Day
2.50309
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-02-27
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2012-12-06
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2011-08-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
18.00000
Number of Facility Reported Incidents
1
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
Nursiong Homes Nearby
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SPRINGFIELD OH 45503 | 1.6 miles away
Springfield Nursing & Independent Living
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SPRINGFIELD OH 45503 | 1.9 miles away
Heartland Of Springfield
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SPRINGFIELD OH 45503 | 2.3 miles away
Eaglewood Care Center
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SPRINGFIELD OH 45503 | 2.7 miles away
Oakwood Village
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SPRINGFIELD OH 45503 | 2.7 miles away
Villa Springfield
701 Villa Road |
SPRINGFIELD OH 45503 | 2.9 miles away
Ridgewood Nursing And Rehab Ce
1600 Saint Paris Pike |
SPRINGFIELD OH 45504 | 2.9 miles away
Forest Glen Health Campus
2150 Montego Drive |
SPRINGFIELD OH 45503 | 3.8 miles away
Southbrook Care Center
2299 S Yellow Springs Street |
SPRINGFIELD OH 45506 | 4.2 miles away
Springfield Masonic Community
2655 W National Rd |
SPRINGFIELD OH 45504 | 4.8 miles away
Belle Manor Nursing Home
107 North Pike Street |
NEW CARLISLE OH 45344 | 13.6 miles away
Dayview Care Center Inc
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NEW CARLISLE OH 45344 | 13.6 miles away
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