Inn At Freedom Village, The - Holland Nursing Home
General Information
UPDATEFederal Provider Number
235548
Provider Name
INN AT FREEDOM VILLAGE, THE
Provider Address
145 COLUMBIA AVE
HOLLAND, MI 49423
HOLLAND, MI 49423
Provider Phone Number
(616) 820-7400
Provider SSA County
690
Provider County Name
Ottawa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
39
Number of Residents in Certified Beds
31
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
CCRC OPCO - HOLLAND, LLC
Date First Approved to Provide Medicare and Medicaid services
1994-03-22
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.79839
Reported LPN Staffing Hours per Resident per Day
1.36452
Reported RN Staffing Hours per Resident per Day
1.61290
Reported Licensed Staffing Hours per Resident per Day
2.97742
Reported Total Nurse Staffing Hours per Resident per Day
5.77581
Reported Physical Therapist Staffing Hours per Resident Per Day
0.24194
Expected CNA Staffing Hours per Resident per Day
2.28091
Expected LPN Staffing Hours per Resident per Day
0.70388
Expected RN Staffing Hours per Resident per Day
1.65544
Expected Total Nurse Staffing Hours per Resident per Day
4.64024
Adjusted CNA Staffing Hours per Resident per Day
3.01038
Adjusted LPN Staffing Hours per Resident per Day
1.60901
Adjusted RN Staffing Hours per Resident per Day
0.72800
Adjusted Total Nurse Staffing Hours per Resident per Day
5.01736
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
52
Cycle 1 Standard Survey Health Date
2014-06-06
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
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-05-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
37.33300
Number of Facility Reported Incidents
4
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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