Willow Park Convalescent Home - Cleveland Nursing Home
General Information
UPDATEFederal Provider Number
365828
Provider Name
WILLOW PARK CONVALESCENT HOME
Provider Address
18810 HARVARD AVE
CLEVELAND, OH 44122
CLEVELAND, OH 44122
Provider Phone Number
(216) 752-3600
Provider SSA County
170
Provider County Name
Cuyahoga
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
189
Number of Residents in Certified Beds
134
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
1991-03-07
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
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
2.13881
Reported LPN Staffing Hours per Resident per Day
0.93657
Reported RN Staffing Hours per Resident per Day
0.61978
Reported Licensed Staffing Hours per Resident per Day
1.55634
Reported Total Nurse Staffing Hours per Resident per Day
3.69516
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00784
Expected CNA Staffing Hours per Resident per Day
2.33984
Expected LPN Staffing Hours per Resident per Day
0.73307
Expected RN Staffing Hours per Resident per Day
1.21464
Expected Total Nurse Staffing Hours per Resident per Day
4.28755
Adjusted CNA Staffing Hours per Resident per Day
2.24289
Adjusted LPN Staffing Hours per Resident per Day
1.06040
Adjusted RN Staffing Hours per Resident per Day
0.38127
Adjusted Total Nurse Staffing Hours per Resident per Day
3.47397
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
16
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
170
Cycle 2 Standard Health Survey Date
2013-06-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
170
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
76
Cycle 3 Standard Health Survey Date
2012-04-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
77.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
Number of Fines
1
Total Amount of Fines in Dollars
26390
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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