Heartland of Chillicothe
1058 Columbus St, Chillicothe, OH 45601


Heartland of Chillicothe is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 365576. The address is 1058 Columbus St, Chillicothe, OH 45601. The zip code is 45601. The phone number is 7407735000.


Heartland of Chillicothe · 1058 Columbus St, Chillicothe, OH 45601

Federal Provider Number 365576
Provider Name HEARTLAND OF CHILLICOTHE
Address 1058 COLUMBUS ST
CHILLICOTHE, OH 45601
Phone Number 7407735000
SSA County Code 720
County Name Ross
Ownership Type For profit - Corporation
Certified Beds 99
Certified Beds Residents 90
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name HEARTLAND OF CHILLICOTHE OH LLC
Date First Approved to Provide Medicare Medicaid Services 02/05/1982
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 1
Health Inspection Rating 1
Quality Measure Rating 3
Staffing Rating 1
RN Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 1.60056
Reported LPN Staffing Hours per Resident per Day 1.03167
Reported RN Staffing Hours per Resident per Day 0.66611
Reported Licensed Staffing Hours per Resident per Day 1.69778
Reported Total Nurse Staffing Hours per Resident per Day 3.29834
Reported Physical Therapist Staffing Hours per Resident Per Day 0.06444
Expected CNA Staffing Hours per Resident per Day 2.53454
Expected LPN Staffing Hours per Resident per Day 0.76975
Expected RN Staffing Hours per Resident per Day 1.46111
Expected Total Nurse Staffing Hours per Resident per Day 4.7654
Adjusted CNA Staffing Hours per Resident per Day 1.54951
Adjusted LPN Staffing Hours per Resident per Day 1.11242
Adjusted RN Staffing Hours per Resident per Day 0.34064
Adjusted Total Nurse Staffing Hours per Resident per Day 2.78996
Cycle 1 Total Number of Health Deficiencies 3
Cycle 1 Number of Standard Health Deficiencies 2
Cycle 1 Number of Complaint Health Deficiencies 1
Cycle 1 Health Deficiency Score 191
Cycle 1 Standard Survey Health Date 05/04/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Health Revisit Score 0
Cycle 1 Total Health Score 191
Cycle 2 Total Number of Health Deficiencies 7
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Number of Complaint Health Deficiencies 2
Cycle 2 Health Deficiency Score 32
Cycle 2 Standard Health Survey Date 02/25/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Health Revisit Score 0
Cycle 2 Total Health Score 32
Cycle 3 Total Number of Health Deficiencies 3
Cycle 3 Number of Standard Health Deficiencies 2
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 28
Cycle 3 Standard Health Survey Date 11/20/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Health Revisit Score 0
Cycle 3 Total Health Score 28
Total Weighted Health Survey Score 110.833
Number of Facility Reported Incidents 0
Number of Substantiated Complaints 3
Number of Fines 1
Total Amount of Fines in Dollars $2080.00
Number of Payment Denials 0
Total Number of Penalties 1
Processing Date 08/01/2017

Owner or Manager · Heartland of Chillicothe

Owner Name Role Association Date
ALLEN, MARTIN (Individual) DIRECTOR since 07/02/2012
CAMPBELL, RAYMOND (Individual) MANAGING EMPLOYEE since 01/03/2017
CARLYLE MC PARTNERS, L.P. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/21/2007
CARLYLE PARTNERS V MC HOLDINGS, L.P. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/21/2007
CARLYLE PARTNERS V MC, L.P. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/21/2007
HCR HEALTHCARE, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/21/2007
HCR II HEALTHCARE, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/21/2007
HCR III HEALTHCARE, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/21/2007
HCR IV HEALTHCARE, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 12/21/2007
HCR MANOR CARE SERVICES LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/20/2007
HCR MANORCARE HEARTLAND LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/07/2011
HCR MANORCARE INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
HCR MANORCARE OPERATIONS II, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/07/2011
HEALTHCARE OPERATIONS HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 10/31/2016
HEALTHCARE OPERATIONS INVESTMENTS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 10/31/2016
HOOPS, KATHRYN (Individual) OFFICER since 12/21/2007
KACZOR, ELIZABETH (Individual) OFFICER since 09/30/2012
KIGHT, DANIEL (Individual) OFFICER since 09/30/2012
KILE, THOMAS (Individual) OFFICER since 12/21/2007
LANNING, DAVID (Individual) OFFICER since 05/01/2015
MANOR CARE INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 08/17/2007
MC OPERATIONS INVESTMENTS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 10/31/2016
MCCORMICK, PATRICIA (Individual) OFFICER since 07/02/2012
ORMOND, PAUL (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
ORMOND, PAUL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/01/2007
PARKER, DAVID (Individual) OFFICER since 09/15/2011
QUALITY CARE PROPERTIES INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 10/31/2016
SHIPMAN, DEAN (Individual) MANAGING EMPLOYEE since 05/01/2016

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