Springfield Masonic Community - Springfield Nursing Home
General Information
UPDATEFederal Provider Number
366116
Provider Name
SPRINGFIELD MASONIC COMMUNITY
Provider Address
2655 W NATIONAL RD
SPRINGFIELD, OH 45504
SPRINGFIELD, OH 45504
Provider Phone Number
(937) 525-3000
Provider SSA County
110
Provider County Name
Clark
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
144
Number of Residents in Certified Beds
132
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE OHIO MASONIC HOME
Date First Approved to Provide Medicare and Medicaid services
1997-04-14
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
2.82197
Reported LPN Staffing Hours per Resident per Day
0.88674
Reported RN Staffing Hours per Resident per Day
0.58447
Reported Licensed Staffing Hours per Resident per Day
1.47121
Reported Total Nurse Staffing Hours per Resident per Day
4.29318
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04318
Expected CNA Staffing Hours per Resident per Day
2.48631
Expected LPN Staffing Hours per Resident per Day
0.61190
Expected RN Staffing Hours per Resident per Day
1.04968
Expected Total Nurse Staffing Hours per Resident per Day
4.14789
Adjusted CNA Staffing Hours per Resident per Day
2.78495
Adjusted LPN Staffing Hours per Resident per Day
1.20280
Adjusted RN Staffing Hours per Resident per Day
0.41605
Adjusted Total Nurse Staffing Hours per Resident per Day
4.17209
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-03-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2011-09-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
12.66700
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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