Maple Wood Care Centre - Streetsboro Nursing Home
General Information
UPDATEFederal Provider Number
365718
Provider Name
MAPLE WOOD CARE CENTRE
Provider Address
1645 MAPLEWOOD DR
STREETSBORO, OH 44241
STREETSBORO, OH 44241
Provider Phone Number
(330) 626-3031
Provider SSA County
680
Provider County Name
Portage
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
124
Number of Residents in Certified Beds
104
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
1988-11-28
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
2.19567
Reported LPN Staffing Hours per Resident per Day
0.50625
Reported RN Staffing Hours per Resident per Day
0.98317
Reported Licensed Staffing Hours per Resident per Day
1.48942
Reported Total Nurse Staffing Hours per Resident per Day
3.68509
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07163
Expected CNA Staffing Hours per Resident per Day
2.31132
Expected LPN Staffing Hours per Resident per Day
0.65803
Expected RN Staffing Hours per Resident per Day
1.17768
Expected Total Nurse Staffing Hours per Resident per Day
4.14703
Adjusted CNA Staffing Hours per Resident per Day
2.33093
Adjusted LPN Staffing Hours per Resident per Day
0.63855
Adjusted RN Staffing Hours per Resident per Day
0.62379
Adjusted Total Nurse Staffing Hours per Resident per Day
3.58190
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-09-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-06-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
2080
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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