Wayside Farm Inc - Peninsula Nursing Home
General Information
UPDATEFederal Provider Number
366323
Provider Name
WAYSIDE FARM INC
Provider Address
4557 QUICK RD
PENINSULA, OH 44264
PENINSULA, OH 44264
Provider Phone Number
(330) 923-7828
Provider SSA County
780
Provider County Name
Summit
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
95
Number of Residents in Certified Beds
94
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2005-12-08
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.02074
Reported LPN Staffing Hours per Resident per Day
1.04840
Reported RN Staffing Hours per Resident per Day
0.35691
Reported Licensed Staffing Hours per Resident per Day
1.40532
Reported Total Nurse Staffing Hours per Resident per Day
3.42605
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06064
Expected CNA Staffing Hours per Resident per Day
2.39447
Expected LPN Staffing Hours per Resident per Day
0.70606
Expected RN Staffing Hours per Resident per Day
1.32589
Expected Total Nurse Staffing Hours per Resident per Day
4.42641
Adjusted CNA Staffing Hours per Resident per Day
2.07073
Adjusted LPN Staffing Hours per Resident per Day
1.23243
Adjusted RN Staffing Hours per Resident per Day
0.20114
Adjusted Total Nurse Staffing Hours per Resident per Day
3.11992
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-05-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-01-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2011-09-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
56.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
6
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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