Lake Park Nursing Facility - Sylvania Nursing Home
General Information
UPDATEFederal Provider Number
365066
Provider Name
LAKE PARK NURSING FACILITY
Provider Address
5100 HARROUN RD
SYLVANIA, OH 43560
SYLVANIA, OH 43560
Provider Phone Number
(419) 824-1000
Provider SSA County
490
Provider County Name
Lucas
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
140
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PROMEDICA CONTINUING CARE SERVICES CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
3
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
2.50982
Reported LPN Staffing Hours per Resident per Day
1.07589
Reported RN Staffing Hours per Resident per Day
1.50089
Reported Licensed Staffing Hours per Resident per Day
2.57679
Reported Total Nurse Staffing Hours per Resident per Day
5.08660
Reported Physical Therapist Staffing Hours per Resident Per Day
0.33571
Expected CNA Staffing Hours per Resident per Day
2.19895
Expected LPN Staffing Hours per Resident per Day
0.65923
Expected RN Staffing Hours per Resident per Day
1.36273
Expected Total Nurse Staffing Hours per Resident per Day
4.22092
Adjusted CNA Staffing Hours per Resident per Day
2.80058
Adjusted LPN Staffing Hours per Resident per Day
1.35459
Adjusted RN Staffing Hours per Resident per Day
0.82295
Adjusted Total Nurse Staffing Hours per Resident per Day
4.85761
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-01-15
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
15.33300
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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