Meadowbrook Manor - Fowler Nursing Home
General Information
UPDATEFederal Provider Number
365902
Provider Name
MEADOWBROOK MANOR
Provider Address
3090 FIVE POINTS HARTFORD
FOWLER, OH 44418
FOWLER, OH 44418
Provider Phone Number
(330) 772-5253
Provider SSA County
790
Provider County Name
Trumbull
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
54
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CONCORD CARE CENTER OF HARTFORD, INC.
Date First Approved to Provide Medicare and Medicaid services
1993-01-29
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.01226
Reported LPN Staffing Hours per Resident per Day
0.62547
Reported RN Staffing Hours per Resident per Day
0.52358
Reported Licensed Staffing Hours per Resident per Day
1.14906
Reported Total Nurse Staffing Hours per Resident per Day
3.16131
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00566
Expected CNA Staffing Hours per Resident per Day
2.04130
Expected LPN Staffing Hours per Resident per Day
0.63599
Expected RN Staffing Hours per Resident per Day
1.07607
Expected Total Nurse Staffing Hours per Resident per Day
3.75336
Adjusted CNA Staffing Hours per Resident per Day
2.41880
Adjusted LPN Staffing Hours per Resident per Day
0.81627
Adjusted RN Staffing Hours per Resident per Day
0.36356
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39507
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
115
Cycle 1 Standard Survey Health Date
2015-03-05
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
115
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-08-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
90.83300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
Number of Fines
1
Total Amount of Fines in Dollars
3250
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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