Hickory Creek Of Athens - The Plains Nursing Home
General Information
UPDATEFederal Provider Number
365589
Provider Name
HICKORY CREEK OF ATHENS
Provider Address
51 EAST 4TH STREET
THE PLAINS, OH 45780
THE PLAINS, OH 45780
Provider Phone Number
(740) 797-4561
Provider SSA County
40
Provider County Name
Athens
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
127
Number of Residents in Certified Beds
114
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
51 THE PLAINS, INC.
Date First Approved to Provide Medicare and Medicaid services
1982-10-07
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
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
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
2.00482
Reported LPN Staffing Hours per Resident per Day
0.57193
Reported RN Staffing Hours per Resident per Day
0.75482
Reported Licensed Staffing Hours per Resident per Day
1.32675
Reported Total Nurse Staffing Hours per Resident per Day
3.33157
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01360
Expected CNA Staffing Hours per Resident per Day
2.71199
Expected LPN Staffing Hours per Resident per Day
0.88717
Expected RN Staffing Hours per Resident per Day
1.35439
Expected Total Nurse Staffing Hours per Resident per Day
4.95354
Adjusted CNA Staffing Hours per Resident per Day
1.81388
Adjusted LPN Staffing Hours per Resident per Day
0.53508
Adjusted RN Staffing Hours per Resident per Day
0.41643
Adjusted Total Nurse Staffing Hours per Resident per Day
2.71103
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
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
20
Cycle 2 Standard Health Survey Date
2012-11-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2011-08-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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