Willows At Bellevue - Bellevue Nursing Home
General Information
UPDATEFederal Provider Number
366365
Provider Name
WILLOWS AT BELLEVUE
Provider Address
101 AUXILIARY DRIVE
BELLEVUE, OH 44811
BELLEVUE, OH 44811
Provider Phone Number
(419) 483-5000
Provider SSA County
730
Provider County Name
Sandusky
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRILOGY HEALTHCARE OF BELLEVUE, LLC
Date First Approved to Provide Medicare and Medicaid services
2008-07-09
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
2
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
2.41415
Reported LPN Staffing Hours per Resident per Day
1.16509
Reported RN Staffing Hours per Resident per Day
0.90849
Reported Licensed Staffing Hours per Resident per Day
2.07358
Reported Total Nurse Staffing Hours per Resident per Day
4.48773
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10660
Expected CNA Staffing Hours per Resident per Day
2.50751
Expected LPN Staffing Hours per Resident per Day
0.69988
Expected RN Staffing Hours per Resident per Day
1.21480
Expected Total Nurse Staffing Hours per Resident per Day
4.42219
Adjusted CNA Staffing Hours per Resident per Day
2.36235
Adjusted LPN Staffing Hours per Resident per Day
1.38170
Adjusted RN Staffing Hours per Resident per Day
0.55880
Adjusted Total Nurse Staffing Hours per Resident per Day
4.09064
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
2014-05-15
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-02-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-11-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
6.00000
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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