Holly Convalescent Center - Holly Nursing Home
General Information
UPDATEFederal Provider Number
230000000000000000000000000000
Provider Name
HOLLY CONVALESCENT CENTER
Provider Address
313 SHERWOOD ST
HOLLY, MI 48442
HOLLY, MI 48442
Provider Phone Number
2486349281
Provider SSA County
620
Provider County Name
Oakland
Ownership Type
For profit - Corporation
Number of Certified Beds
66
Number of Residents in Certified Beds
62
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
2
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
2.21210
Reported LPN Staffing Hours per Resident per Day
0.38629
Reported RN Staffing Hours per Resident per Day
0.64516
Reported Licensed Staffing Hours per Resident per Day
1.03145
Reported Total Nurse Staffing Hours per Resident per Day
3.24355
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05565
Expected CNA Staffing Hours per Resident per Day
2.23597
Expected LPN Staffing Hours per Resident per Day
0.56589
Expected RN Staffing Hours per Resident per Day
0.76506
Expected Total Nurse Staffing Hours per Resident per Day
3.56692
Adjusted CNA Staffing Hours per Resident per Day
2.42751
Adjusted LPN Staffing Hours per Resident per Day
0.56658
Adjusted RN Staffing Hours per Resident per Day
0.63010
Adjusted Total Nurse Staffing Hours per Resident per Day
3.66547
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-11-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-01-16
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
14
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
139
Cycle 3 Standard Health Survey Date
2012-10-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
139
Total Weighted Health Survey Score
65.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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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