Pine Grove Healthcare Center - Geneva Nursing Home
General Information
UPDATEFederal Provider Number
366366
Provider Name
PINE GROVE HEALTHCARE CENTER
Provider Address
840 SHERMAN STREET
GENEVA, OH 44041
GENEVA, OH 44041
Provider Phone Number
(440) 415-0502
Provider SSA County
30
Provider County Name
Ashtabula
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
67
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
840 SHERMAN HEALTHCARE, INC.
Date First Approved to Provide Medicare and Medicaid services
2008-10-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
2.23516
Reported LPN Staffing Hours per Resident per Day
0.69297
Reported RN Staffing Hours per Resident per Day
0.80859
Reported Licensed Staffing Hours per Resident per Day
1.50156
Reported Total Nurse Staffing Hours per Resident per Day
3.73672
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08047
Expected CNA Staffing Hours per Resident per Day
2.28808
Expected LPN Staffing Hours per Resident per Day
0.71167
Expected RN Staffing Hours per Resident per Day
1.25038
Expected Total Nurse Staffing Hours per Resident per Day
4.25013
Adjusted CNA Staffing Hours per Resident per Day
2.39695
Adjusted LPN Staffing Hours per Resident per Day
0.80819
Adjusted RN Staffing Hours per Resident per Day
0.48320
Adjusted Total Nurse Staffing Hours per Resident per Day
3.54398
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
2014-09-04
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-06-06
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2012-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
2.66700
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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