Liberty Nursing Center Of Beavercreek Inc - Beaver Creek Nursing Home
General Information
UPDATEFederal Provider Number
366400
Provider Name
LIBERTY NURSING CENTER OF BEAVERCREEK INC
Provider Address
3854 PARK OVERLOOKE DRIVE
BEAVER CREEK, OH 45431
BEAVER CREEK, OH 45431
Provider Phone Number
9374299655
Provider SSA County
290
Provider County Name
Greene
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
72
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY NURSING CENTER OF BEAVERCREEK INC
Date First Approved to Provide Medicare and Medicaid services
2012-11-16
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.69167
Reported LPN Staffing Hours per Resident per Day
0.92569
Reported RN Staffing Hours per Resident per Day
0.60694
Reported Licensed Staffing Hours per Resident per Day
1.53264
Reported Total Nurse Staffing Hours per Resident per Day
3.22430
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04583
Expected CNA Staffing Hours per Resident per Day
2.41250
Expected LPN Staffing Hours per Resident per Day
0.70992
Expected RN Staffing Hours per Resident per Day
1.44309
Expected Total Nurse Staffing Hours per Resident per Day
4.56551
Adjusted CNA Staffing Hours per Resident per Day
1.72056
Adjusted LPN Staffing Hours per Resident per Day
1.08227
Adjusted RN Staffing Hours per Resident per Day
0.31426
Adjusted Total Nurse Staffing Hours per Resident per Day
2.84674
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-01-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
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
2012-10-10
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
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
-0001-11-30
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
21.60000
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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