Park Village Health Care Center Inc - Dover Nursing Home
General Information
UPDATEFederal Provider Number
366093
Provider Name
PARK VILLAGE HEALTH CARE CENTER INC
Provider Address
1525 CRATER AVENUE
DOVER, OH 44622
DOVER, OH 44622
Provider Phone Number
(330) 364-4436
Provider SSA County
800
Provider County Name
Tuscarawas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PARK VILLAGE HEALTH CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1996-11-14
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.48901
Reported LPN Staffing Hours per Resident per Day
0.43352
Reported RN Staffing Hours per Resident per Day
0.83901
Reported Licensed Staffing Hours per Resident per Day
1.27253
Reported Total Nurse Staffing Hours per Resident per Day
3.76154
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07912
Expected CNA Staffing Hours per Resident per Day
2.73591
Expected LPN Staffing Hours per Resident per Day
0.65849
Expected RN Staffing Hours per Resident per Day
1.07784
Expected Total Nurse Staffing Hours per Resident per Day
4.47225
Adjusted CNA Staffing Hours per Resident per Day
2.23227
Adjusted LPN Staffing Hours per Resident per Day
0.54643
Adjusted RN Staffing Hours per Resident per Day
0.58163
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39033
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-06-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
30.66700
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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