White Oak Manor - Warren Nursing Home
General Information
UPDATEFederal Provider Number
365748
Provider Name
WHITE OAK MANOR
Provider Address
1926 RIDGE AVENUE
WARREN, OH 44484
WARREN, OH 44484
Provider Phone Number
3303694672
Provider SSA County
790
Provider County Name
Trumbull
Ownership Type
For profit - Corporation
Number of Certified Beds
62
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RIDGECREST HEALTHCARE GROUP, INC.
Date First Approved to Provide Medicare and Medicaid services
1989-07-31
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
1
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
1.96552
Reported LPN Staffing Hours per Resident per Day
0.96638
Reported RN Staffing Hours per Resident per Day
0.32500
Reported Licensed Staffing Hours per Resident per Day
1.29138
Reported Total Nurse Staffing Hours per Resident per Day
3.25690
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02845
Expected CNA Staffing Hours per Resident per Day
2.26108
Expected LPN Staffing Hours per Resident per Day
0.65219
Expected RN Staffing Hours per Resident per Day
1.21939
Expected Total Nurse Staffing Hours per Resident per Day
4.13267
Adjusted CNA Staffing Hours per Resident per Day
2.13296
Adjusted LPN Staffing Hours per Resident per Day
1.22984
Adjusted RN Staffing Hours per Resident per Day
0.19915
Adjusted Total Nurse Staffing Hours per Resident per Day
3.17670
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
19
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
128
Cycle 1 Standard Survey Health Date
2014-08-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
128
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-04-26
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
13
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-02-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
103.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
2665
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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