Ohio Nursing Homes >> Waverly Nursing Homes >> National Church Residences Bristol Village

National Church Residences Bristol Village - Waverly Nursing Home

General Information

UPDATE
Federal Provider Number
365742
Provider Name
NATIONAL CHURCH RESIDENCES BRISTOL VILLAGE
Provider Address
444 CHERRY ST
WAVERLY, OH 45690
Provider Phone Number
(740) 947-2113
Provider SSA County
670
Provider County Name
Pike
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
75
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WAVERLY CARE CENTER INC2
Date First Approved to Provide Medicare and Medicaid services
1989-06-29
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
2.61484
Reported LPN Staffing Hours per Resident per Day
0.55469
Reported RN Staffing Hours per Resident per Day
0.94688
Reported Licensed Staffing Hours per Resident per Day
1.50156
Reported Total Nurse Staffing Hours per Resident per Day
4.11641
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04375
Expected CNA Staffing Hours per Resident per Day
2.49596
Expected LPN Staffing Hours per Resident per Day
0.71648
Expected RN Staffing Hours per Resident per Day
1.21630
Expected Total Nurse Staffing Hours per Resident per Day
4.42873
Adjusted CNA Staffing Hours per Resident per Day
2.57057
Adjusted LPN Staffing Hours per Resident per Day
0.64258
Adjusted RN Staffing Hours per Resident per Day
0.58169
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74663
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
8
Cycle 1 Standard Survey Health Date
2015-03-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-11-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
18.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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