Oak Grove Manor - Mansfield Nursing Home
General Information
UPDATEFederal Provider Number
365837
Provider Name
OAK GROVE MANOR
Provider Address
1670 CRIDER RD
MANSFIELD, OH 44903
MANSFIELD, OH 44903
Provider Phone Number
(419) 589-6222
Provider SSA County
710
Provider County Name
Richland
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
75
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEALTHCARE VENTURES OF OHIO LLC
Date First Approved to Provide Medicare and Medicaid services
1991-05-06
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
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.08700
Reported LPN Staffing Hours per Resident per Day
0.44300
Reported RN Staffing Hours per Resident per Day
0.91400
Reported Licensed Staffing Hours per Resident per Day
1.35700
Reported Total Nurse Staffing Hours per Resident per Day
3.44400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01400
Expected CNA Staffing Hours per Resident per Day
2.50755
Expected LPN Staffing Hours per Resident per Day
0.83912
Expected RN Staffing Hours per Resident per Day
1.49446
Expected Total Nurse Staffing Hours per Resident per Day
4.84114
Adjusted CNA Staffing Hours per Resident per Day
2.04218
Adjusted LPN Staffing Hours per Resident per Day
0.43819
Adjusted RN Staffing Hours per Resident per Day
0.45698
Adjusted Total Nurse Staffing Hours per Resident per Day
2.86760
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2012-11-29
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
13
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2011-08-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
60.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
11
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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