Lebanon Country Manor - Lebanon Nursing Home
General Information
UPDATEFederal Provider Number
365920
Provider Name
LEBANON COUNTRY MANOR
Provider Address
700 MONROE ROAD
LEBANON, OH 45036
LEBANON, OH 45036
Provider Phone Number
(513) 932-0105
Provider SSA County
840
Provider County Name
Warren
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
95
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LEBANON HEALTH CARE LLC
Date First Approved to Provide Medicare and Medicaid services
1993-09-01
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
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
1.97667
Reported LPN Staffing Hours per Resident per Day
0.53000
Reported RN Staffing Hours per Resident per Day
1.09133
Reported Licensed Staffing Hours per Resident per Day
1.62133
Reported Total Nurse Staffing Hours per Resident per Day
3.59800
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05933
Expected CNA Staffing Hours per Resident per Day
2.31735
Expected LPN Staffing Hours per Resident per Day
0.70757
Expected RN Staffing Hours per Resident per Day
1.27403
Expected Total Nurse Staffing Hours per Resident per Day
4.29895
Adjusted CNA Staffing Hours per Resident per Day
2.09298
Adjusted LPN Staffing Hours per Resident per Day
0.62171
Adjusted RN Staffing Hours per Resident per Day
0.64005
Adjusted Total Nurse Staffing Hours per Resident per Day
3.37366
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
2014-02-27
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2012-12-06
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
24
Cycle 3 Standard Health Survey Date
2011-08-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
5.33300
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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