Heartland Of Centerville - Centerville Nursing Home
General Information
UPDATEFederal Provider Number
366100
Provider Name
HEARTLAND OF CENTERVILLE
Provider Address
1001 ALEX BELL ROAD
CENTERVILLE, OH 45459
CENTERVILLE, OH 45459
Provider Phone Number
(937) 436-9700
Provider SSA County
580
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
140
Number of Residents in Certified Beds
105
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEARTLAND OF CENTERVILLE OH LLC
Date First Approved to Provide Medicare and Medicaid services
1997-01-14
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
2.06333
Reported LPN Staffing Hours per Resident per Day
0.66381
Reported RN Staffing Hours per Resident per Day
0.91381
Reported Licensed Staffing Hours per Resident per Day
1.57762
Reported Total Nurse Staffing Hours per Resident per Day
3.64095
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08810
Expected CNA Staffing Hours per Resident per Day
2.61800
Expected LPN Staffing Hours per Resident per Day
0.71848
Expected RN Staffing Hours per Resident per Day
1.25741
Expected Total Nurse Staffing Hours per Resident per Day
4.59389
Adjusted CNA Staffing Hours per Resident per Day
1.93384
Adjusted LPN Staffing Hours per Resident per Day
0.76685
Adjusted RN Staffing Hours per Resident per Day
0.54302
Adjusted Total Nurse Staffing Hours per Resident per Day
3.19475
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
10
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-09-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-05-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-02-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
42.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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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