Maple View Manor - Bainbridge Nursing Home
General Information
UPDATEFederal Provider Number
366227
Provider Name
MAPLE VIEW MANOR
Provider Address
430 SOUTH MAPLE STREET
BAINBRIDGE, OH 45612
BAINBRIDGE, OH 45612
Provider Phone Number
(740) 634-3301
Provider SSA County
720
Provider County Name
Ross
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
20
Number of Residents in Certified Beds
15
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EARLEY & ROSS OF ROSS COUNTY,LLC
Date First Approved to Provide Medicare and Medicaid services
2001-09-20
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.56333
Reported LPN Staffing Hours per Resident per Day
0.40667
Reported RN Staffing Hours per Resident per Day
1.01667
Reported Licensed Staffing Hours per Resident per Day
1.42333
Reported Total Nurse Staffing Hours per Resident per Day
2.98667
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.37223
Expected LPN Staffing Hours per Resident per Day
0.73579
Expected RN Staffing Hours per Resident per Day
1.03381
Expected Total Nurse Staffing Hours per Resident per Day
4.14183
Adjusted CNA Staffing Hours per Resident per Day
1.61702
Adjusted LPN Staffing Hours per Resident per Day
0.45874
Adjusted RN Staffing Hours per Resident per Day
0.73481
Adjusted Total Nurse Staffing Hours per Resident per Day
2.90668
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-04-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-03-06
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
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
20
Total Weighted Health Survey Score
17.33300
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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