Herrick Manor - Tecumseh Nursing Home
General Information
UPDATEFederal Provider Number
235560
Provider Name
HERRICK MANOR
Provider Address
502 EAST POTTAWATAMIE
TECUMSEH, MI 49286
TECUMSEH, MI 49286
Provider Phone Number
(517) 424-3365
Provider SSA County
450
Provider County Name
Lenawee
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
25
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HERRICK MEMORIAL HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1995-02-09
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.20000
Reported LPN Staffing Hours per Resident per Day
0.64000
Reported RN Staffing Hours per Resident per Day
1.00400
Reported Licensed Staffing Hours per Resident per Day
1.64400
Reported Total Nurse Staffing Hours per Resident per Day
3.84400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.43400
Expected CNA Staffing Hours per Resident per Day
2.20521
Expected LPN Staffing Hours per Resident per Day
0.61379
Expected RN Staffing Hours per Resident per Day
1.10525
Expected Total Nurse Staffing Hours per Resident per Day
3.92425
Adjusted CNA Staffing Hours per Resident per Day
2.44790
Adjusted LPN Staffing Hours per Resident per Day
0.86544
Adjusted RN Staffing Hours per Resident per Day
0.67875
Adjusted Total Nurse Staffing Hours per Resident per Day
3.94847
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-01-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
29.33300
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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