Kingston Care Center Of Sylvania - Sylvania Nursing Home
General Information
UPDATEFederal Provider Number
366305
Provider Name
KINGSTON CARE CENTER OF SYLVANIA
Provider Address
4121 KING ROAD
SYLVANIA, OH 43560
SYLVANIA, OH 43560
Provider Phone Number
(419) 517-4666
Provider SSA County
490
Provider County Name
Lucas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
127
Number of Residents in Certified Beds
124
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KINGSTON CARE CENTER OF SYLVANIA, LLC
Date First Approved to Provide Medicare and Medicaid services
2005-01-10
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
2.24355
Reported LPN Staffing Hours per Resident per Day
1.21331
Reported RN Staffing Hours per Resident per Day
0.82097
Reported Licensed Staffing Hours per Resident per Day
2.03427
Reported Total Nurse Staffing Hours per Resident per Day
4.27783
Reported Physical Therapist Staffing Hours per Resident Per Day
0.25484
Expected CNA Staffing Hours per Resident per Day
2.44713
Expected LPN Staffing Hours per Resident per Day
0.67036
Expected RN Staffing Hours per Resident per Day
1.26434
Expected Total Nurse Staffing Hours per Resident per Day
4.38183
Adjusted CNA Staffing Hours per Resident per Day
2.24957
Adjusted LPN Staffing Hours per Resident per Day
1.50225
Adjusted RN Staffing Hours per Resident per Day
0.48518
Adjusted Total Nurse Staffing Hours per Resident per Day
3.93523
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-03-13
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2012-12-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2011-09-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
23.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
9
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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