Shepherd Of The Valley-boardman - Youngstown Nursing Home
General Information
UPDATEFederal Provider Number
365580
Provider Name
SHEPHERD OF THE VALLEY-BOARDMAN
Provider Address
7148 WEST BLVD
YOUNGSTOWN, OH 44512
YOUNGSTOWN, OH 44512
Provider Phone Number
(330) 726-9061
Provider SSA County
510
Provider County Name
Mahoning
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
89
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Date First Approved to Provide Medicare and Medicaid services
1982-03-22
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.26429
Reported LPN Staffing Hours per Resident per Day
1.21753
Reported RN Staffing Hours per Resident per Day
0.58312
Reported Licensed Staffing Hours per Resident per Day
1.80065
Reported Total Nurse Staffing Hours per Resident per Day
4.06494
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07727
Expected CNA Staffing Hours per Resident per Day
2.50415
Expected LPN Staffing Hours per Resident per Day
0.70553
Expected RN Staffing Hours per Resident per Day
1.34009
Expected Total Nurse Staffing Hours per Resident per Day
4.54978
Adjusted CNA Staffing Hours per Resident per Day
2.21867
Adjusted LPN Staffing Hours per Resident per Day
1.43233
Adjusted RN Staffing Hours per Resident per Day
0.32513
Adjusted Total Nurse Staffing Hours per Resident per Day
3.60136
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-02-05
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
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-07-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
52.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
2145
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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