Shepherd Of The Valley - Niles - Niles Nursing Home
General Information
UPDATEFederal Provider Number
365298
Provider Name
SHEPHERD OF THE VALLEY - NILES
Provider Address
1500 MCKINLEY AVENUE
NILES, OH 44446
NILES, OH 44446
Provider Phone Number
(330) 544-0771
Provider SSA County
790
Provider County Name
Trumbull
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
97
Number of Residents in Certified Beds
70
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
1974-09-03
Continuing Care Retirement Community
Y
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
3
Health Inspection Rating Footnote
QM Rating
2
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
2.17000
Reported LPN Staffing Hours per Resident per Day
0.84143
Reported RN Staffing Hours per Resident per Day
0.67286
Reported Licensed Staffing Hours per Resident per Day
1.51429
Reported Total Nurse Staffing Hours per Resident per Day
3.68429
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04357
Expected CNA Staffing Hours per Resident per Day
2.59292
Expected LPN Staffing Hours per Resident per Day
0.67618
Expected RN Staffing Hours per Resident per Day
1.13474
Expected Total Nurse Staffing Hours per Resident per Day
4.40385
Adjusted CNA Staffing Hours per Resident per Day
2.05348
Adjusted LPN Staffing Hours per Resident per Day
1.03283
Adjusted RN Staffing Hours per Resident per Day
0.44306
Adjusted Total Nurse Staffing Hours per Resident per Day
3.37228
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-04-12
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-03-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
27.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
2275
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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