Maple Woods Manor - Clio Nursing Home
General Information
UPDATEFederal Provider Number
235518
Provider Name
MAPLE WOODS MANOR
Provider Address
13137 NORTH CLIO ROAD
CLIO, MI 48420
CLIO, MI 48420
Provider Phone Number
8106862600
Provider SSA County
240
Provider County Name
Genesee
Ownership Type
For profit - Corporation
Number of Certified Beds
151
Number of Residents in Certified Beds
142
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1992-03-27
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.53732
Reported LPN Staffing Hours per Resident per Day
0.36232
Reported RN Staffing Hours per Resident per Day
0.28310
Reported Licensed Staffing Hours per Resident per Day
0.64542
Reported Total Nurse Staffing Hours per Resident per Day
2.18274
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03204
Expected CNA Staffing Hours per Resident per Day
2.44990
Expected LPN Staffing Hours per Resident per Day
0.62741
Expected RN Staffing Hours per Resident per Day
1.00540
Expected Total Nurse Staffing Hours per Resident per Day
4.08272
Adjusted CNA Staffing Hours per Resident per Day
1.53970
Adjusted LPN Staffing Hours per Resident per Day
0.47931
Adjusted RN Staffing Hours per Resident per Day
0.21040
Adjusted Total Nurse Staffing Hours per Resident per Day
2.15504
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-06-20
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
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-07-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
23.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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