Laurels Of Shane Hill - Rockford Nursing Home

General Information

UPDATE
Federal Provider Number
366125
Provider Name
LAURELS OF SHANE HILL
Provider Address
10731 STATE ROUTE 118
ROCKFORD, OH 45882
Provider Phone Number
4193632620
Provider SSA County
550
Provider County Name
Mercer
Ownership Type
For profit - Corporation
Number of Certified Beds
81
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE LAURELS OF ROCKFORD, INC.
Date First Approved to Provide Medicare and Medicaid services
1997-04-30
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
2
QM Rating Footnote
Staffing Rating
3
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
1.98986
Reported LPN Staffing Hours per Resident per Day
0.69797
Reported RN Staffing Hours per Resident per Day
0.77297
Reported Licensed Staffing Hours per Resident per Day
1.47095
Reported Total Nurse Staffing Hours per Resident per Day
3.46080
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07635
Expected CNA Staffing Hours per Resident per Day
2.51567
Expected LPN Staffing Hours per Resident per Day
0.66372
Expected RN Staffing Hours per Resident per Day
1.06305
Expected Total Nurse Staffing Hours per Resident per Day
4.24243
Adjusted CNA Staffing Hours per Resident per Day
1.94085
Adjusted LPN Staffing Hours per Resident per Day
0.87283
Adjusted RN Staffing Hours per Resident per Day
0.54331
Adjusted Total Nurse Staffing Hours per Resident per Day
3.28824
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-03-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2012-12-20
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
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
24
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
1885
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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