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Van Wert Manor - Van Wert Nursing Home

General Information

UPDATE
Federal Provider Number
365246
Provider Name
VAN WERT MANOR
Provider Address
160 FOX RD
VAN WERT, OH 45891
Provider Phone Number
(419) 238-6655
Provider SSA County
820
Provider County Name
Van Wert
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HCF OF VAN WERT, INC.
Date First Approved to Provide Medicare and Medicaid services
1970-06-25
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
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
1
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
2.38804
Reported LPN Staffing Hours per Resident per Day
0.75870
Reported RN Staffing Hours per Resident per Day
0.62772
Reported Licensed Staffing Hours per Resident per Day
1.38641
Reported Total Nurse Staffing Hours per Resident per Day
3.77446
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02935
Expected CNA Staffing Hours per Resident per Day
2.46096
Expected LPN Staffing Hours per Resident per Day
0.71924
Expected RN Staffing Hours per Resident per Day
1.16589
Expected Total Nurse Staffing Hours per Resident per Day
4.34608
Adjusted CNA Staffing Hours per Resident per Day
2.38100
Adjusted LPN Staffing Hours per Resident per Day
0.87554
Adjusted RN Staffing Hours per Resident per Day
0.40230
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50073
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-04-03
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-01-31
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-10-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
5.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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