Heartland Victorian Village - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
365315
Provider Name
HEARTLAND VICTORIAN VILLAGE
Provider Address
920 THURBER DRIVE WEST
COLUMBUS, OH 43215
COLUMBUS, OH 43215
Provider Phone Number
(614) 464-2273
Provider SSA County
250
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEARTLAND-VICTORIAN VILLAGE OF COLUMBUS OH LLC
Date First Approved to Provide Medicare and Medicaid services
1975-02-10
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
2
QM Rating Footnote
Staffing Rating
3
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
2.12105
Reported LPN Staffing Hours per Resident per Day
0.87211
Reported RN Staffing Hours per Resident per Day
0.75789
Reported Licensed Staffing Hours per Resident per Day
1.63000
Reported Total Nurse Staffing Hours per Resident per Day
3.75105
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14947
Expected CNA Staffing Hours per Resident per Day
2.43156
Expected LPN Staffing Hours per Resident per Day
0.71628
Expected RN Staffing Hours per Resident per Day
1.22384
Expected Total Nurse Staffing Hours per Resident per Day
4.37168
Adjusted CNA Staffing Hours per Resident per Day
2.14036
Adjusted LPN Staffing Hours per Resident per Day
1.01057
Adjusted RN Staffing Hours per Resident per Day
0.46272
Adjusted Total Nurse Staffing Hours per Resident per Day
3.45865
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-02-05
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
104
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
104
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
58.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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