Otsego Memorial Hospital Ltcu - Gaylord Nursing Home
General Information
UPDATEFederal Provider Number
235006
Provider Name
OTSEGO MEMORIAL HOSPITAL LTCU
Provider Address
825 N CENTER ST
GAYLORD, MI 49735
GAYLORD, MI 49735
Provider Phone Number
(989) 731-2131
Provider SSA County
680
Provider County Name
Otsego
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
34
Number of Residents in Certified Beds
29
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
OTSEGO MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.95517
Reported LPN Staffing Hours per Resident per Day
0.53276
Reported RN Staffing Hours per Resident per Day
1.79310
Reported Licensed Staffing Hours per Resident per Day
2.32586
Reported Total Nurse Staffing Hours per Resident per Day
5.28103
Reported Physical Therapist Staffing Hours per Resident Per Day
0.91552
Expected CNA Staffing Hours per Resident per Day
2.62944
Expected LPN Staffing Hours per Resident per Day
0.66867
Expected RN Staffing Hours per Resident per Day
1.00022
Expected Total Nurse Staffing Hours per Resident per Day
4.29832
Adjusted CNA Staffing Hours per Resident per Day
2.75766
Adjusted LPN Staffing Hours per Resident per Day
0.66130
Adjusted RN Staffing Hours per Resident per Day
1.33951
Adjusted Total Nurse Staffing Hours per Resident per Day
4.95247
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-11-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-11-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
48.00000
Number of Facility Reported Incidents
6
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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