Minerva Park Healthcare And Rehabilitation Center - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
365806
Provider Name
MINERVA PARK HEALTHCARE AND REHABILITATION CENTER
Provider Address
5460 CLEVELAND AVENUE
COLUMBUS, OH 43231
COLUMBUS, OH 43231
Provider Phone Number
(614) 882-2490
Provider SSA County
250
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
101
Number of Residents in Certified Beds
78
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP COLUMBUS LLC
Date First Approved to Provide Medicare and Medicaid services
1990-09-30
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
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
1.91026
Reported LPN Staffing Hours per Resident per Day
0.90769
Reported RN Staffing Hours per Resident per Day
0.90449
Reported Licensed Staffing Hours per Resident per Day
1.81218
Reported Total Nurse Staffing Hours per Resident per Day
3.72244
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14615
Expected CNA Staffing Hours per Resident per Day
2.45495
Expected LPN Staffing Hours per Resident per Day
0.66790
Expected RN Staffing Hours per Resident per Day
1.09732
Expected Total Nurse Staffing Hours per Resident per Day
4.22017
Adjusted CNA Staffing Hours per Resident per Day
1.90928
Adjusted LPN Staffing Hours per Resident per Day
1.12799
Adjusted RN Staffing Hours per Resident per Day
0.61590
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55549
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-09-11
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
25
Cycle 2 Number of Standard Health Deficiencies
20
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
164
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
164
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-03-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
66.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
3200
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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