Hennis Care Centre Of Bolivar - Bolivar Nursing Home
General Information
UPDATEFederal Provider Number
366200
Provider Name
HENNIS CARE CENTRE OF BOLIVAR
Provider Address
300 YANT STREET, NW
BOLIVAR, OH 44612
BOLIVAR, OH 44612
Provider Phone Number
(330) 874-9999
Provider SSA County
800
Provider County Name
Tuscarawas
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
115
Number of Residents in Certified Beds
101
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MEGCO MANAGEMENT INCORPORATED
Date First Approved to Provide Medicare and Medicaid services
2000-08-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.32525
Reported LPN Staffing Hours per Resident per Day
0.58267
Reported RN Staffing Hours per Resident per Day
1.36040
Reported Licensed Staffing Hours per Resident per Day
1.94307
Reported Total Nurse Staffing Hours per Resident per Day
5.26832
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06287
Expected CNA Staffing Hours per Resident per Day
2.64408
Expected LPN Staffing Hours per Resident per Day
0.72883
Expected RN Staffing Hours per Resident per Day
1.36375
Expected Total Nurse Staffing Hours per Resident per Day
4.73666
Adjusted CNA Staffing Hours per Resident per Day
3.08582
Adjusted LPN Staffing Hours per Resident per Day
0.66355
Adjusted RN Staffing Hours per Resident per Day
0.74537
Adjusted Total Nurse Staffing Hours per Resident per Day
4.48334
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-06-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-04-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
3900
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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