Wintersong Village - Delaware Nursing Home
General Information
UPDATEFederal Provider Number
366026
Provider Name
WINTERSONG VILLAGE
Provider Address
478 S SANDUSKY ST
DELAWARE, OH 43015
DELAWARE, OH 43015
Provider Phone Number
7403698741
Provider SSA County
210
Provider County Name
Delaware
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
37
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRY CLUB RETIREMENT CENTER V LLC
Date First Approved to Provide Medicare and Medicaid services
1995-09-18
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
4
Overall Rating Footnote
Health Inspection Rating
2
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
3.92568
Reported LPN Staffing Hours per Resident per Day
1.65676
Reported RN Staffing Hours per Resident per Day
1.01351
Reported Licensed Staffing Hours per Resident per Day
2.67027
Reported Total Nurse Staffing Hours per Resident per Day
6.59595
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05811
Expected CNA Staffing Hours per Resident per Day
2.41229
Expected LPN Staffing Hours per Resident per Day
0.68837
Expected RN Staffing Hours per Resident per Day
1.35896
Expected Total Nurse Staffing Hours per Resident per Day
4.45962
Adjusted CNA Staffing Hours per Resident per Day
3.99307
Adjusted LPN Staffing Hours per Resident per Day
1.99763
Adjusted RN Staffing Hours per Resident per Day
0.55726
Adjusted Total Nurse Staffing Hours per Resident per Day
5.96186
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-12-17
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
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
96
Cycle 2 Standard Health Survey Date
2013-09-05
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-05-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
44.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
24050
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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DELAWARE OH 43015 | 1.9 miles away
Arbors At Delaware
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DELAWARE OH 43015 | 3.1 miles away
Country View Of Sunbury
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WESTERVILLE OH 43081 | 12.9 miles away
Village At Westerville Nrsg Ctr The
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