Rae-ann West Park - Cleveland Nursing Home
General Information
UPDATEFederal Provider Number
366058
Provider Name
RAE-ANN WEST PARK
Provider Address
4650 ROCKY RIVER DR
CLEVELAND, OH 44135
CLEVELAND, OH 44135
Provider Phone Number
(216) 267-5445
Provider SSA County
170
Provider County Name
Cuyahoga
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RAE-ANN INC.
Date First Approved to Provide Medicare and Medicaid services
1996-09-01
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
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
1.76837
Reported LPN Staffing Hours per Resident per Day
0.62347
Reported RN Staffing Hours per Resident per Day
1.11429
Reported Licensed Staffing Hours per Resident per Day
1.73776
Reported Total Nurse Staffing Hours per Resident per Day
3.50613
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01633
Expected CNA Staffing Hours per Resident per Day
2.44268
Expected LPN Staffing Hours per Resident per Day
0.71268
Expected RN Staffing Hours per Resident per Day
1.17744
Expected Total Nurse Staffing Hours per Resident per Day
4.33280
Adjusted CNA Staffing Hours per Resident per Day
1.77635
Adjusted LPN Staffing Hours per Resident per Day
0.72610
Adjusted RN Staffing Hours per Resident per Day
0.70713
Adjusted Total Nurse Staffing Hours per Resident per Day
3.26183
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2012-10-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2011-06-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
31.33300
Number of Facility Reported Incidents
0
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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