Lakewood Hospital Skilled Nurs - Lakewood Nursing Home
General Information
UPDATEFederal Provider Number
365749
Provider Name
LAKEWOOD HOSPITAL SKILLED NURS
Provider Address
14519 DETROIT AVE
LAKEWOOD, OH 44107
LAKEWOOD, OH 44107
Provider Phone Number
(216) 529-7005
Provider SSA County
170
Provider County Name
Cuyahoga
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
25
Number of Residents in Certified Beds
20
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
LAKEWOOD HOSPITAL ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
1989-10-05
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
2.73250
Reported LPN Staffing Hours per Resident per Day
1.32250
Reported RN Staffing Hours per Resident per Day
3.66750
Reported Licensed Staffing Hours per Resident per Day
4.99000
Reported Total Nurse Staffing Hours per Resident per Day
7.72250
Reported Physical Therapist Staffing Hours per Resident Per Day
0.57250
Expected CNA Staffing Hours per Resident per Day
2.72568
Expected LPN Staffing Hours per Resident per Day
1.43440
Expected RN Staffing Hours per Resident per Day
1.80865
Expected Total Nurse Staffing Hours per Resident per Day
5.96873
Adjusted CNA Staffing Hours per Resident per Day
2.45984
Adjusted LPN Staffing Hours per Resident per Day
0.76525
Adjusted RN Staffing Hours per Resident per Day
1.51514
Adjusted Total Nurse Staffing Hours per Resident per Day
5.21528
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
2014-03-27
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-01-17
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2011-09-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
2.00000
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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