Holland Home - Fulton Manor - Grand Rapids Nursing Home
General Information
UPDATEFederal Provider Number
235435
Provider Name
HOLLAND HOME - FULTON MANOR
Provider Address
1450 E FULTON ST
GRAND RAPIDS, MI 49503
GRAND RAPIDS, MI 49503
Provider Phone Number
6166432600
Provider SSA County
400
Provider County Name
Kent
Ownership Type
Non profit - Corporation
Number of Certified Beds
82
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HOLLAND HOME
Date First Approved to Provide Medicare and Medicaid services
1985-02-14
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
2.71438
Reported LPN Staffing Hours per Resident per Day
1.05616
Reported RN Staffing Hours per Resident per Day
0.76370
Reported Licensed Staffing Hours per Resident per Day
1.81986
Reported Total Nurse Staffing Hours per Resident per Day
4.53424
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01575
Expected CNA Staffing Hours per Resident per Day
2.74834
Expected LPN Staffing Hours per Resident per Day
0.59090
Expected RN Staffing Hours per Resident per Day
0.82246
Expected Total Nurse Staffing Hours per Resident per Day
4.16170
Adjusted CNA Staffing Hours per Resident per Day
2.42338
Adjusted LPN Staffing Hours per Resident per Day
1.48352
Adjusted RN Staffing Hours per Resident per Day
0.69382
Adjusted Total Nurse Staffing Hours per Resident per Day
4.39173
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-06-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-08-03
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
46
Cycle 3 Total Health Score
138
Total Weighted Health Survey Score
40.33300
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
4
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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