Maple Valley Nursing Home - Maple City Nursing Home

General Information

UPDATE
Federal Provider Number
235588
Provider Name
MAPLE VALLEY NURSING HOME
Provider Address
1086 W. BURDICKVILLE ROAD
MAPLE CITY, MI 49664
Provider Phone Number
(231) 228-5895
Provider SSA County
440
Provider County Name
Leelanau
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
25
Number of Residents in Certified Beds
21
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MAPLE VALLEY NURSING HOME OF MAPLE CITY, INC.
Date First Approved to Provide Medicare and Medicaid services
1998-12-15
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
1.65000
Reported LPN Staffing Hours per Resident per Day
0.73571
Reported RN Staffing Hours per Resident per Day
0.57143
Reported Licensed Staffing Hours per Resident per Day
1.30714
Reported Total Nurse Staffing Hours per Resident per Day
2.95714
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.26719
Expected LPN Staffing Hours per Resident per Day
0.51593
Expected RN Staffing Hours per Resident per Day
0.73018
Expected Total Nurse Staffing Hours per Resident per Day
3.51330
Adjusted CNA Staffing Hours per Resident per Day
1.78574
Adjusted LPN Staffing Hours per Resident per Day
1.18357
Adjusted RN Staffing Hours per Resident per Day
0.58475
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39281
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-04-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
27.33300
Number of Facility Reported Incidents
1
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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