Henry Ford Village, Inc - Dearborn Nursing Home
General Information
UPDATEFederal Provider Number
235593
Provider Name
HENRY FORD VILLAGE, INC
Provider Address
15101 FORD RD
DEARBORN, MI 48126
DEARBORN, MI 48126
Provider Phone Number
(313) 582-2097
Provider SSA County
810
Provider County Name
Wayne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
89
Number of Residents in Certified Beds
87
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HENRY FORD VILLAGE, INC.
Date First Approved to Provide Medicare and Medicaid services
2000-04-03
Continuing Care Retirement Community
Y
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
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.71954
Reported LPN Staffing Hours per Resident per Day
1.52874
Reported RN Staffing Hours per Resident per Day
0.91954
Reported Licensed Staffing Hours per Resident per Day
2.44828
Reported Total Nurse Staffing Hours per Resident per Day
5.16782
Reported Physical Therapist Staffing Hours per Resident Per Day
0.21667
Expected CNA Staffing Hours per Resident per Day
2.35269
Expected LPN Staffing Hours per Resident per Day
0.68481
Expected RN Staffing Hours per Resident per Day
1.34842
Expected Total Nurse Staffing Hours per Resident per Day
4.38593
Adjusted CNA Staffing Hours per Resident per Day
2.83629
Adjusted LPN Staffing Hours per Resident per Day
1.85286
Adjusted RN Staffing Hours per Resident per Day
0.50954
Adjusted Total Nurse Staffing Hours per Resident per Day
4.74950
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
108
Cycle 1 Standard Survey Health Date
2015-03-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2014-02-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-01-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
86.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
11
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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