Lutheran Village At Wolfcreek - Holland Nursing Home
General Information
UPDATEFederal Provider Number
366192
Provider Name
LUTHERAN VILLAGE AT WOLFCREEK
Provider Address
2001 PERRYSBURG HOLLAND ROAD
HOLLAND, OH 43528
HOLLAND, OH 43528
Provider Phone Number
4198615600
Provider SSA County
490
Provider County Name
Lucas
Ownership Type
Non profit - Corporation
Number of Certified Beds
135
Number of Residents in Certified Beds
125
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
2000-01-28
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
2
Health Inspection Rating Footnote
QM Rating
4
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
2.54040
Reported LPN Staffing Hours per Resident per Day
1.34280
Reported RN Staffing Hours per Resident per Day
0.69240
Reported Licensed Staffing Hours per Resident per Day
2.03520
Reported Total Nurse Staffing Hours per Resident per Day
4.57560
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07480
Expected CNA Staffing Hours per Resident per Day
2.58607
Expected LPN Staffing Hours per Resident per Day
0.79297
Expected RN Staffing Hours per Resident per Day
1.35493
Expected Total Nurse Staffing Hours per Resident per Day
4.73397
Adjusted CNA Staffing Hours per Resident per Day
2.41036
Adjusted LPN Staffing Hours per Resident per Day
1.40551
Adjusted RN Staffing Hours per Resident per Day
0.38184
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89605
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-02-21
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
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-10-27
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
12
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
46.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
Number of Fines
2
Total Amount of Fines in Dollars
4492
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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