Holly Hill Nursing Home - Newbury Nursing Home
General Information
UPDATEFederal Provider Number
365947
Provider Name
HOLLY HILL NURSING HOME
Provider Address
10190 FAIRMOUNT RD
NEWBURY, OH 44065
NEWBURY, OH 44065
Provider Phone Number
(440) 338-8220
Provider SSA County
280
Provider County Name
Geauga
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
76
Number of Residents in Certified Beds
76
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FAIRMOUNT NURSING HOME INC
Date First Approved to Provide Medicare and Medicaid services
1994-01-01
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
2.79079
Reported LPN Staffing Hours per Resident per Day
0.52632
Reported RN Staffing Hours per Resident per Day
0.93816
Reported Licensed Staffing Hours per Resident per Day
1.46447
Reported Total Nurse Staffing Hours per Resident per Day
4.25527
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03553
Expected CNA Staffing Hours per Resident per Day
2.57872
Expected LPN Staffing Hours per Resident per Day
0.75171
Expected RN Staffing Hours per Resident per Day
1.34863
Expected Total Nurse Staffing Hours per Resident per Day
4.67905
Adjusted CNA Staffing Hours per Resident per Day
2.65549
Adjusted LPN Staffing Hours per Resident per Day
0.58114
Adjusted RN Staffing Hours per Resident per Day
0.51978
Adjusted Total Nurse Staffing Hours per Resident per Day
3.66582
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-09-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-06-14
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-03-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
12.00000
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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