Lutheran Memorial Home, Inc - Sandusky Nursing Home
General Information
UPDATEFederal Provider Number
366219
Provider Name
LUTHERAN MEMORIAL HOME, INC
Provider Address
795 BARDSHAR ROAD
SANDUSKY, OH 44870
SANDUSKY, OH 44870
Provider Phone Number
(419) 625-4046
Provider SSA County
220
Provider County Name
Erie
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
56
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN HOMES SOCIETY, INC.
Date First Approved to Provide Medicare and Medicaid services
2001-05-11
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
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.84615
Reported LPN Staffing Hours per Resident per Day
0.88942
Reported RN Staffing Hours per Resident per Day
0.40096
Reported Licensed Staffing Hours per Resident per Day
1.29038
Reported Total Nurse Staffing Hours per Resident per Day
3.13653
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01250
Expected CNA Staffing Hours per Resident per Day
2.55958
Expected LPN Staffing Hours per Resident per Day
0.73939
Expected RN Staffing Hours per Resident per Day
1.34175
Expected Total Nurse Staffing Hours per Resident per Day
4.64072
Adjusted CNA Staffing Hours per Resident per Day
1.76978
Adjusted LPN Staffing Hours per Resident per Day
0.99841
Adjusted RN Staffing Hours per Resident per Day
0.22329
Adjusted Total Nurse Staffing Hours per Resident per Day
2.72437
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
22.00000
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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