Provincial House Of Adrian - Adrian Nursing Home
General Information
UPDATEFederal Provider Number
235287
Provider Name
PROVINCIAL HOUSE OF ADRIAN
Provider Address
700 LAKESHIRE TR
ADRIAN, MI 49221
ADRIAN, MI 49221
Provider Phone Number
(517) 263-0781
Provider SSA County
450
Provider County Name
Lenawee
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
117
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LENAWEE LONG TERM CARE
Date First Approved to Provide Medicare and Medicaid services
1976-05-01
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.89700
Reported LPN Staffing Hours per Resident per Day
0.55700
Reported RN Staffing Hours per Resident per Day
0.85700
Reported Licensed Staffing Hours per Resident per Day
1.41400
Reported Total Nurse Staffing Hours per Resident per Day
4.31100
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06250
Expected CNA Staffing Hours per Resident per Day
2.38398
Expected LPN Staffing Hours per Resident per Day
0.64249
Expected RN Staffing Hours per Resident per Day
1.00181
Expected Total Nurse Staffing Hours per Resident per Day
4.02828
Adjusted CNA Staffing Hours per Resident per Day
2.98173
Adjusted LPN Staffing Hours per Resident per Day
0.71955
Adjusted RN Staffing Hours per Resident per Day
0.63920
Adjusted Total Nurse Staffing Hours per Resident per Day
4.31381
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-05-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-02-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-02-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
46.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
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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