Ohio Nursing Homes >> Sidney Nursing Homes >> Pavilion The

Pavilion The - Sidney Nursing Home

General Information

UPDATE
Federal Provider Number
365297
Provider Name
PAVILION THE
Provider Address
705 FULTON STREET
SIDNEY, OH 45365
Provider Phone Number
(937) 492-9591
Provider SSA County
760
Provider County Name
Shelby
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PAVILION CARE CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1973-07-24
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
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.17500
Reported LPN Staffing Hours per Resident per Day
0.89773
Reported RN Staffing Hours per Resident per Day
0.70000
Reported Licensed Staffing Hours per Resident per Day
1.59773
Reported Total Nurse Staffing Hours per Resident per Day
3.77273
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04545
Expected CNA Staffing Hours per Resident per Day
2.34842
Expected LPN Staffing Hours per Resident per Day
0.75414
Expected RN Staffing Hours per Resident per Day
1.34077
Expected Total Nurse Staffing Hours per Resident per Day
4.44333
Adjusted CNA Staffing Hours per Resident per Day
2.27250
Adjusted LPN Staffing Hours per Resident per Day
0.98804
Adjusted RN Staffing Hours per Resident per Day
0.39010
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42254
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
20
Cycle 2 Standard Health Survey Date
2013-08-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-05-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
9.33300
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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