Park Geriatric Village - Highland Park Nursing Home
General Information
UPDATEFederal Provider Number
235463
Provider Name
PARK GERIATRIC VILLAGE
Provider Address
111 FORD AVE
HIGHLAND PARK, MI 48203
HIGHLAND PARK, MI 48203
Provider Phone Number
3138833585
Provider SSA County
810
Provider County Name
Wayne
Ownership Type
For profit - Corporation
Number of Certified Beds
114
Number of Residents in Certified Beds
104
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PARK GERIATRIC VILLAGE, INC
Date First Approved to Provide Medicare and Medicaid services
1987-09-28
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.32163
Reported LPN Staffing Hours per Resident per Day
0.91971
Reported RN Staffing Hours per Resident per Day
0.32596
Reported Licensed Staffing Hours per Resident per Day
1.24567
Reported Total Nurse Staffing Hours per Resident per Day
3.56730
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05481
Expected CNA Staffing Hours per Resident per Day
2.15190
Expected LPN Staffing Hours per Resident per Day
0.53938
Expected RN Staffing Hours per Resident per Day
0.79755
Expected Total Nurse Staffing Hours per Resident per Day
3.48883
Adjusted CNA Staffing Hours per Resident per Day
2.64724
Adjusted LPN Staffing Hours per Resident per Day
1.41524
Adjusted RN Staffing Hours per Resident per Day
0.30538
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12156
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-11-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-10-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
19
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
120
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
120
Total Weighted Health Survey Score
87.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
7
Number of Fines
3
Total Amount of Fines in Dollars
16869
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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