Patriot Ridge Community - Fairborn Nursing Home
General Information
UPDATEFederal Provider Number
365979
Provider Name
PATRIOT RIDGE COMMUNITY
Provider Address
789 STONEYBROOK TERRACE
FAIRBORN, OH 45324
FAIRBORN, OH 45324
Provider Phone Number
(937) 878-0262
Provider SSA County
290
Provider County Name
Greene
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
100
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UNITED CHURCH HOMES, INC.
Date First Approved to Provide Medicare and Medicaid services
1994-08-31
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
5
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
2.74651
Reported LPN Staffing Hours per Resident per Day
0.96453
Reported RN Staffing Hours per Resident per Day
0.58488
Reported Licensed Staffing Hours per Resident per Day
1.54942
Reported Total Nurse Staffing Hours per Resident per Day
4.29592
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07035
Expected CNA Staffing Hours per Resident per Day
2.35255
Expected LPN Staffing Hours per Resident per Day
0.67340
Expected RN Staffing Hours per Resident per Day
1.17585
Expected Total Nurse Staffing Hours per Resident per Day
4.20179
Adjusted CNA Staffing Hours per Resident per Day
2.86460
Adjusted LPN Staffing Hours per Resident per Day
1.18884
Adjusted RN Staffing Hours per Resident per Day
0.37167
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12120
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
32
Cycle 1 Standard Survey Health Date
2014-08-07
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
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-05-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-02-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
2275
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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