Woodside Village Care Center - Mount Gilead Nursing Home
General Information
UPDATEFederal Provider Number
366028
Provider Name
WOODSIDE VILLAGE CARE CENTER
Provider Address
841 W MARION RD
MOUNT GILEAD, OH 43338
MOUNT GILEAD, OH 43338
Provider Phone Number
(419) 947-2015
Provider SSA County
600
Provider County Name
Morrow
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ORION MANSFIELD LLC
Date First Approved to Provide Medicare and Medicaid services
1995-11-01
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
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.37093
Reported LPN Staffing Hours per Resident per Day
0.66860
Reported RN Staffing Hours per Resident per Day
0.54419
Reported Licensed Staffing Hours per Resident per Day
1.21279
Reported Total Nurse Staffing Hours per Resident per Day
3.58372
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02849
Expected CNA Staffing Hours per Resident per Day
2.40875
Expected LPN Staffing Hours per Resident per Day
0.66789
Expected RN Staffing Hours per Resident per Day
1.17060
Expected Total Nurse Staffing Hours per Resident per Day
4.24724
Adjusted CNA Staffing Hours per Resident per Day
2.41518
Adjusted LPN Staffing Hours per Resident per Day
0.83088
Adjusted RN Staffing Hours per Resident per Day
0.34736
Adjusted Total Nurse Staffing Hours per Resident per Day
3.40118
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-07-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
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
2013-04-08
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2011-12-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
36.66700
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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