Mother Angeline Mccrory Manor - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
365436
Provider Name
MOTHER ANGELINE MCCRORY MANOR
Provider Address
5199 EAST BROAD STREET
COLUMBUS, OH 43213
COLUMBUS, OH 43213
Provider Phone Number
(614) 751-5700
Provider SSA County
250
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
147
Number of Residents in Certified Beds
136
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MOTHER ANGELINE MCCRORY MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
1980-03-19
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
4
QM Rating Footnote
Staffing Rating
4
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
3.23529
Reported LPN Staffing Hours per Resident per Day
0.64669
Reported RN Staffing Hours per Resident per Day
1.06176
Reported Licensed Staffing Hours per Resident per Day
1.70846
Reported Total Nurse Staffing Hours per Resident per Day
4.94374
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05919
Expected CNA Staffing Hours per Resident per Day
2.54336
Expected LPN Staffing Hours per Resident per Day
0.68194
Expected RN Staffing Hours per Resident per Day
1.14962
Expected Total Nurse Staffing Hours per Resident per Day
4.37492
Adjusted CNA Staffing Hours per Resident per Day
3.12124
Adjusted LPN Staffing Hours per Resident per Day
0.78710
Adjusted RN Staffing Hours per Resident per Day
0.69010
Adjusted Total Nurse Staffing Hours per Resident per Day
4.55499
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-03-07
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2011-09-15
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
9.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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