Koester Pavilion - Troy Nursing Home
General Information
UPDATEFederal Provider Number
365735
Provider Name
KOESTER PAVILION
Provider Address
3232 NORTH COUNTY ROAD 25A
TROY, OH 45373
TROY, OH 45373
Provider Phone Number
(937) 440-7663
Provider SSA County
560
Provider County Name
Miami
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
140
Number of Residents in Certified Beds
121
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UVMC NURSING CARE, INC
Date First Approved to Provide Medicare and Medicaid services
1989-05-08
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
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.63388
Reported LPN Staffing Hours per Resident per Day
0.88306
Reported RN Staffing Hours per Resident per Day
0.64174
Reported Licensed Staffing Hours per Resident per Day
1.52479
Reported Total Nurse Staffing Hours per Resident per Day
4.15868
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03182
Expected CNA Staffing Hours per Resident per Day
2.54742
Expected LPN Staffing Hours per Resident per Day
0.81837
Expected RN Staffing Hours per Resident per Day
1.31349
Expected Total Nurse Staffing Hours per Resident per Day
4.67928
Adjusted CNA Staffing Hours per Resident per Day
2.53698
Adjusted LPN Staffing Hours per Resident per Day
0.89561
Adjusted RN Staffing Hours per Resident per Day
0.36506
Adjusted Total Nurse Staffing Hours per Resident per Day
3.58244
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-12-04
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-08-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-06-08
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
9.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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