Liberty Nursing Center Of Bellbrook Inc - Bellbrook Nursing Home
General Information
UPDATEFederal Provider Number
365626
Provider Name
LIBERTY NURSING CENTER OF BELLBROOK INC
Provider Address
1957 NORTH LAKEMAN DRIVE
BELLBROOK, OH 45305
BELLBROOK, OH 45305
Provider Phone Number
(937) 848-7800
Provider SSA County
290
Provider County Name
Greene
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
27
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY NURSING CENTER OF BELLBROOK INC
Date First Approved to Provide Medicare and Medicaid services
1984-07-17
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
5
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
2.02963
Reported LPN Staffing Hours per Resident per Day
0.97037
Reported RN Staffing Hours per Resident per Day
0.78333
Reported Licensed Staffing Hours per Resident per Day
1.75370
Reported Total Nurse Staffing Hours per Resident per Day
3.78333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04259
Expected CNA Staffing Hours per Resident per Day
2.37418
Expected LPN Staffing Hours per Resident per Day
0.80034
Expected RN Staffing Hours per Resident per Day
1.61822
Expected Total Nurse Staffing Hours per Resident per Day
4.79274
Adjusted CNA Staffing Hours per Resident per Day
2.09761
Adjusted LPN Staffing Hours per Resident per Day
1.00633
Adjusted RN Staffing Hours per Resident per Day
0.36170
Adjusted Total Nurse Staffing Hours per Resident per Day
3.18194
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
20
Cycle 1 Standard Survey Health Date
2014-05-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-02-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2011-10-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
18.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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