Wellspring Lutheran Services - Livonia Nursing Home
General Information
UPDATEFederal Provider Number
235587
Provider Name
WELLSPRING LUTHERAN SERVICES
Provider Address
28910 PLYMOUTH ROAD
LIVONIA, MI 48150
LIVONIA, MI 48150
Provider Phone Number
(734) 425-4814
Provider SSA County
810
Provider County Name
Wayne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
88
Number of Residents in Certified Beds
76
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN HOMES OF MICHIGAN, INC
Date First Approved to Provide Medicare and Medicaid services
1998-12-11
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.81974
Reported LPN Staffing Hours per Resident per Day
0.86447
Reported RN Staffing Hours per Resident per Day
0.86447
Reported Licensed Staffing Hours per Resident per Day
1.72895
Reported Total Nurse Staffing Hours per Resident per Day
4.54868
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12303
Expected CNA Staffing Hours per Resident per Day
2.45335
Expected LPN Staffing Hours per Resident per Day
0.62995
Expected RN Staffing Hours per Resident per Day
1.11007
Expected Total Nurse Staffing Hours per Resident per Day
4.19337
Adjusted CNA Staffing Hours per Resident per Day
2.82014
Adjusted LPN Staffing Hours per Resident per Day
1.13900
Adjusted RN Staffing Hours per Resident per Day
0.58188
Adjusted Total Nurse Staffing Hours per Resident per Day
4.37245
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-09-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
119
Cycle 2 Standard Health Survey Date
2013-08-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
119
Cycle 3 Total Number of Health Deficiencies
20
Cycle 3 Number of Standard Health Deficiencies
17
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
140
Cycle 3 Standard Health Survey Date
2012-07-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
140
Total Weighted Health Survey Score
91.00000
Number of Facility Reported Incidents
14
Number of Substantiated Complaints
13
Number of Fines
2
Total Amount of Fines in Dollars
22263
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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