Liberty Nursing Center Of Xenia - Xenia Nursing Home
General Information
UPDATEFederal Provider Number
365187
Provider Name
LIBERTY NURSING CENTER OF XENIA
Provider Address
126 WILSON DRIVE
XENIA, OH 45385
XENIA, OH 45385
Provider Phone Number
(937) 376-2121
Provider SSA County
290
Provider County Name
Greene
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
53
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY NURSING CENTER OF XENIA
Date First Approved to Provide Medicare and Medicaid services
1967-11-21
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.47674
Reported LPN Staffing Hours per Resident per Day
0.98488
Reported RN Staffing Hours per Resident per Day
0.83721
Reported Licensed Staffing Hours per Resident per Day
1.82209
Reported Total Nurse Staffing Hours per Resident per Day
4.29883
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04651
Expected CNA Staffing Hours per Resident per Day
2.53021
Expected LPN Staffing Hours per Resident per Day
0.78429
Expected RN Staffing Hours per Resident per Day
1.61734
Expected Total Nurse Staffing Hours per Resident per Day
4.93184
Adjusted CNA Staffing Hours per Resident per Day
2.40184
Adjusted LPN Staffing Hours per Resident per Day
1.04228
Adjusted RN Staffing Hours per Resident per Day
0.38679
Adjusted Total Nurse Staffing Hours per Resident per Day
3.51353
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
2014-11-13
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
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-08-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
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
12
Cycle 3 Standard Health Survey Date
2012-10-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
10.00000
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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