Villa Camillus The - Columbia Station Nursing Home
General Information
UPDATEFederal Provider Number
365583
Provider Name
VILLA CAMILLUS THE
Provider Address
10515 E RIVER RD
COLUMBIA STATION, OH 44028
COLUMBIA STATION, OH 44028
Provider Phone Number
4402365091
Provider SSA County
480
Provider County Name
Lorain
Ownership Type
For profit - Corporation
Number of Certified Beds
75
Number of Residents in Certified Beds
66
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VILLA CAMILLUS INC
Date First Approved to Provide Medicare and Medicaid services
1982-07-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.45455
Reported LPN Staffing Hours per Resident per Day
0.86591
Reported RN Staffing Hours per Resident per Day
0.60000
Reported Licensed Staffing Hours per Resident per Day
1.46591
Reported Total Nurse Staffing Hours per Resident per Day
3.92046
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00455
Expected CNA Staffing Hours per Resident per Day
2.34381
Expected LPN Staffing Hours per Resident per Day
0.66606
Expected RN Staffing Hours per Resident per Day
1.08677
Expected Total Nurse Staffing Hours per Resident per Day
4.09664
Adjusted CNA Staffing Hours per Resident per Day
2.56963
Adjusted LPN Staffing Hours per Resident per Day
1.07903
Adjusted RN Staffing Hours per Resident per Day
0.41253
Adjusted Total Nurse Staffing Hours per Resident per Day
3.85755
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-05-09
Cycle 2 Number of Health Revisits
1
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
28
Cycle 3 Standard Health Survey Date
2012-02-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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