Manor At Perrysburg - Perrysburg Nursing Home

General Information

UPDATE
Federal Provider Number
366022
Provider Name
MANOR AT PERRYSBURG
Provider Address
250 MANOR DRIVE
PERRYSBURG, OH 43551
Provider Phone Number
(419) 874-0306
Provider SSA County
880
Provider County Name
Wood
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
125
Number of Residents in Certified Beds
120
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HCF OF PERRYSBURG, INC.
Date First Approved to Provide Medicare and Medicaid services
1995-09-19
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
2
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
2.20833
Reported LPN Staffing Hours per Resident per Day
0.66792
Reported RN Staffing Hours per Resident per Day
0.67708
Reported Licensed Staffing Hours per Resident per Day
1.34500
Reported Total Nurse Staffing Hours per Resident per Day
3.55333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04833
Expected CNA Staffing Hours per Resident per Day
2.52675
Expected LPN Staffing Hours per Resident per Day
0.68488
Expected RN Staffing Hours per Resident per Day
1.23092
Expected Total Nurse Staffing Hours per Resident per Day
4.44256
Adjusted CNA Staffing Hours per Resident per Day
2.14448
Adjusted LPN Staffing Hours per Resident per Day
0.80944
Adjusted RN Staffing Hours per Resident per Day
0.41100
Adjusted Total Nurse Staffing Hours per Resident per Day
3.22407
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-05-22
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
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-03-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-11-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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