Willow Brook Christian Home - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
365988
Provider Name
WILLOW BROOK CHRISTIAN HOME
Provider Address
55 LAZELLE RD
COLUMBUS, OH 43235
COLUMBUS, OH 43235
Provider Phone Number
6148853300
Provider SSA County
250
Provider County Name
Franklin
Ownership Type
Non profit - Church related
Number of Certified Beds
50
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WILLOW BROOK CHRISTIAN SERVICES
Date First Approved to Provide Medicare and Medicaid services
1995-01-16
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
2.55435
Reported LPN Staffing Hours per Resident per Day
0.67283
Reported RN Staffing Hours per Resident per Day
0.80109
Reported Licensed Staffing Hours per Resident per Day
1.47391
Reported Total Nurse Staffing Hours per Resident per Day
4.02827
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02283
Expected CNA Staffing Hours per Resident per Day
2.51418
Expected LPN Staffing Hours per Resident per Day
0.65286
Expected RN Staffing Hours per Resident per Day
1.05073
Expected Total Nurse Staffing Hours per Resident per Day
4.21778
Adjusted CNA Staffing Hours per Resident per Day
2.49290
Adjusted LPN Staffing Hours per Resident per Day
0.85538
Adjusted RN Staffing Hours per Resident per Day
0.56967
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84979
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-09-26
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-07-06
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
2.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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