Heartland Of Bellefontaine - Bellefontaine Nursing Home
General Information
UPDATEFederal Provider Number
365615
Provider Name
HEARTLAND OF BELLEFONTAINE
Provider Address
221 NORTH SCHOOL STREET
BELLEFONTAINE, OH 43311
BELLEFONTAINE, OH 43311
Provider Phone Number
(937) 599-5123
Provider SSA County
470
Provider County Name
Logan
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEARTLAND OF BELLEFONTAINE OH LLC
Date First Approved to Provide Medicare and Medicaid services
1984-02-07
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
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
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
1.73867
Reported LPN Staffing Hours per Resident per Day
0.68533
Reported RN Staffing Hours per Resident per Day
0.68400
Reported Licensed Staffing Hours per Resident per Day
1.36933
Reported Total Nurse Staffing Hours per Resident per Day
3.10800
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08067
Expected CNA Staffing Hours per Resident per Day
2.46800
Expected LPN Staffing Hours per Resident per Day
0.76138
Expected RN Staffing Hours per Resident per Day
1.41437
Expected Total Nurse Staffing Hours per Resident per Day
4.64375
Adjusted CNA Staffing Hours per Resident per Day
1.72860
Adjusted LPN Staffing Hours per Resident per Day
0.74710
Adjusted RN Staffing Hours per Resident per Day
0.36135
Adjusted Total Nurse Staffing Hours per Resident per Day
2.69783
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-01-29
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
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
2012-07-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
10.66700
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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