Maison Aine - Stow Nursing Home
General Information
UPDATEFederal Provider Number
365720
Provider Name
MAISON AINE
Provider Address
2910 L'ERMITAGE PL
STOW, OH 44224
STOW, OH 44224
Provider Phone Number
(330) 688-1188
Provider SSA County
780
Provider County Name
Summit
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
150
Number of Residents in Certified Beds
146
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTHERN HEALTH FACILITIES, INC.
Date First Approved to Provide Medicare and Medicaid services
1988-10-20
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
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.68870
Reported LPN Staffing Hours per Resident per Day
0.53219
Reported RN Staffing Hours per Resident per Day
0.91507
Reported Licensed Staffing Hours per Resident per Day
1.44726
Reported Total Nurse Staffing Hours per Resident per Day
4.13596
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11541
Expected CNA Staffing Hours per Resident per Day
2.65793
Expected LPN Staffing Hours per Resident per Day
0.64893
Expected RN Staffing Hours per Resident per Day
1.10213
Expected Total Nurse Staffing Hours per Resident per Day
4.40900
Adjusted CNA Staffing Hours per Resident per Day
2.48210
Adjusted LPN Staffing Hours per Resident per Day
0.68069
Adjusted RN Staffing Hours per Resident per Day
0.62038
Adjusted Total Nurse Staffing Hours per Resident per Day
3.78128
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-11-06
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
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-08-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
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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