Worthington Christian Village - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
365671
Provider Name
WORTHINGTON CHRISTIAN VILLAGE
Provider Address
165 HIGHBLUFFS BLVD
COLUMBUS, OH 43235
COLUMBUS, OH 43235
Provider Phone Number
(614) 846-6076
Provider SSA County
250
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WORTHINGTON CHRISTIAN VILLAGE, INC.
Date First Approved to Provide Medicare and Medicaid services
1986-03-03
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
1.08511
Reported LPN Staffing Hours per Resident per Day
0.56596
Reported RN Staffing Hours per Resident per Day
0.95106
Reported Licensed Staffing Hours per Resident per Day
1.51702
Reported Total Nurse Staffing Hours per Resident per Day
2.60213
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07872
Expected CNA Staffing Hours per Resident per Day
2.69048
Expected LPN Staffing Hours per Resident per Day
0.65102
Expected RN Staffing Hours per Resident per Day
1.06105
Expected Total Nurse Staffing Hours per Resident per Day
4.40255
Adjusted CNA Staffing Hours per Resident per Day
0.98961
Adjusted LPN Staffing Hours per Resident per Day
0.72156
Adjusted RN Staffing Hours per Resident per Day
0.66974
Adjusted Total Nurse Staffing Hours per Resident per Day
2.38247
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-01-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-10-03
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
20.00000
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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