Versailles Health Care Center - Versailles Nursing Home
General Information
UPDATEFederal Provider Number
365900
Provider Name
VERSAILLES HEALTH CARE CENTER
Provider Address
200 MARKER ROAD
VERSAILLES, OH 45380
VERSAILLES, OH 45380
Provider Phone Number
(937) 526-5570
Provider SSA County
190
Provider County Name
Darke
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
105
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE OHIO, INC.
Date First Approved to Provide Medicare and Medicaid services
1993-01-06
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
3
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
2.16000
Reported LPN Staffing Hours per Resident per Day
0.62476
Reported RN Staffing Hours per Resident per Day
0.84905
Reported Licensed Staffing Hours per Resident per Day
1.47381
Reported Total Nurse Staffing Hours per Resident per Day
3.63381
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14143
Expected CNA Staffing Hours per Resident per Day
2.62616
Expected LPN Staffing Hours per Resident per Day
0.64131
Expected RN Staffing Hours per Resident per Day
1.06291
Expected Total Nurse Staffing Hours per Resident per Day
4.33038
Adjusted CNA Staffing Hours per Resident per Day
2.01815
Adjusted LPN Staffing Hours per Resident per Day
0.80858
Adjusted RN Staffing Hours per Resident per Day
0.59686
Adjusted Total Nurse Staffing Hours per Resident per Day
3.38250
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-05-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-11-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
17.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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