Ivy Woods Manor - North Lima Nursing Home
General Information
UPDATEFederal Provider Number
365708
Provider Name
IVY WOODS MANOR
Provider Address
9625 MARKET STREET
NORTH LIMA, OH 44452
NORTH LIMA, OH 44452
Provider Phone Number
(330) 549-3939
Provider SSA County
510
Provider County Name
Mahoning
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
91
Number of Residents in Certified Beds
87
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ROLLING ACRES CARE CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1988-01-28
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
1.82816
Reported LPN Staffing Hours per Resident per Day
0.66897
Reported RN Staffing Hours per Resident per Day
0.73103
Reported Licensed Staffing Hours per Resident per Day
1.40000
Reported Total Nurse Staffing Hours per Resident per Day
3.22816
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05115
Expected CNA Staffing Hours per Resident per Day
2.14365
Expected LPN Staffing Hours per Resident per Day
0.65556
Expected RN Staffing Hours per Resident per Day
1.17148
Expected Total Nurse Staffing Hours per Resident per Day
3.97069
Adjusted CNA Staffing Hours per Resident per Day
2.09258
Adjusted LPN Staffing Hours per Resident per Day
0.84698
Adjusted RN Staffing Hours per Resident per Day
0.46627
Adjusted Total Nurse Staffing Hours per Resident per Day
3.27711
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
20
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-10-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
Number of Fines
1
Total Amount of Fines in Dollars
2080
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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