Lakes Of Monclova Health Campus The - Maumee Nursing Home
General Information
UPDATEFederal Provider Number
366406
Provider Name
LAKES OF MONCLOVA HEALTH CAMPUS THE
Provider Address
6935 MONCLOVA ROAD
MAUMEE, OH 43537
MAUMEE, OH 43537
Provider Phone Number
(419) 866-3030
Provider SSA County
490
Provider County Name
Lucas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRILOGY HEALTHCARE OF LUCAS LLC
Date First Approved to Provide Medicare and Medicaid services
2013-05-23
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.52426
Reported LPN Staffing Hours per Resident per Day
1.59118
Reported RN Staffing Hours per Resident per Day
0.86250
Reported Licensed Staffing Hours per Resident per Day
2.45368
Reported Total Nurse Staffing Hours per Resident per Day
4.97794
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14926
Expected CNA Staffing Hours per Resident per Day
2.46229
Expected LPN Staffing Hours per Resident per Day
0.69312
Expected RN Staffing Hours per Resident per Day
1.21519
Expected Total Nurse Staffing Hours per Resident per Day
4.37060
Adjusted CNA Staffing Hours per Resident per Day
2.51545
Adjusted LPN Staffing Hours per Resident per Day
1.90541
Adjusted RN Staffing Hours per Resident per Day
0.53034
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59104
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-05-23
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
11.20000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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