Wesley Glen Health Services Corp - Columbus Nursing Home

General Information

UPDATE
Federal Provider Number
365504
Provider Name
WESLEY GLEN HEALTH SERVICES CORP
Provider Address
5155 NORTH HIGH STREET
COLUMBUS, OH 43214
Provider Phone Number
6148887492
Provider SSA County
250
Provider County Name
Franklin
Ownership Type
Non profit - Church related
Number of Certified Beds
81
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WESLEY GLEN, INC.
Date First Approved to Provide Medicare and Medicaid services
1980-04-30
Continuing Care Retirement Community
Y
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.44859
Reported LPN Staffing Hours per Resident per Day
0.81690
Reported RN Staffing Hours per Resident per Day
0.85211
Reported Licensed Staffing Hours per Resident per Day
1.66901
Reported Total Nurse Staffing Hours per Resident per Day
4.11760
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05704
Expected CNA Staffing Hours per Resident per Day
2.42681
Expected LPN Staffing Hours per Resident per Day
0.71293
Expected RN Staffing Hours per Resident per Day
1.31334
Expected Total Nurse Staffing Hours per Resident per Day
4.45308
Adjusted CNA Staffing Hours per Resident per Day
2.47572
Adjusted LPN Staffing Hours per Resident per Day
0.95105
Adjusted RN Staffing Hours per Resident per Day
0.48479
Adjusted Total Nurse Staffing Hours per Resident per Day
3.72723
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-03-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2012-12-21
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
6
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-08-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
23.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
2275
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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