Shiloh Springs Care Center Inc
3500 Shiloh Springs Road, Trotwood, OH 45426


Shiloh Springs Care Center Inc is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 366302. The address is 3500 Shiloh Springs Road, Trotwood, OH 45426. The zip code is 45426. The phone number is 9378541180.


Shiloh Springs Care Center Inc · 3500 Shiloh Springs Road, Trotwood, OH 45426

Federal Provider Number 366302
Provider Name SHILOH SPRINGS CARE CENTER INC
Address 3500 SHILOH SPRINGS ROAD
TROTWOOD, OH 45426
Phone Number 9378541180
SSA County Code 580
County Name Montgomery
Ownership Type For profit - Corporation
Certified Beds 84
Certified Beds Residents 72
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name CARRIAGE INN OF TROTWOOD, INC
Date First Approved to Provide Medicare Medicaid Services 12/01/2004
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 2
Health Inspection Rating 3
Quality Measure Rating 2
Staffing Rating 1
RN Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 1.98194
Reported LPN Staffing Hours per Resident per Day 0.73889
Reported RN Staffing Hours per Resident per Day 0.62361
Reported Licensed Staffing Hours per Resident per Day 1.3625
Reported Total Nurse Staffing Hours per Resident per Day 3.34444
Reported Physical Therapist Staffing Hours per Resident Per Day 0.02361
Expected CNA Staffing Hours per Resident per Day 2.46842
Expected LPN Staffing Hours per Resident per Day 0.73121
Expected RN Staffing Hours per Resident per Day 1.28793
Expected Total Nurse Staffing Hours per Resident per Day 4.48757
Adjusted CNA Staffing Hours per Resident per Day 1.97012
Adjusted LPN Staffing Hours per Resident per Day 0.83871
Adjusted RN Staffing Hours per Resident per Day 0.36179
Adjusted Total Nurse Staffing Hours per Resident per Day 3.0041
Cycle 1 Total Number of Health Deficiencies 4
Cycle 1 Number of Standard Health Deficiencies 2
Cycle 1 Number of Complaint Health Deficiencies 2
Cycle 1 Health Deficiency Score 20
Cycle 1 Standard Survey Health Date 07/21/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 20
Cycle 2 Total Number of Health Deficiencies 2
Cycle 2 Number of Standard Health Deficiencies 2
Cycle 2 Health Deficiency Score 12
Cycle 2 Standard Health Survey Date 04/30/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 12
Cycle 3 Total Number of Health Deficiencies 5
Cycle 3 Number of Standard Health Deficiencies 5
Cycle 3 Health Deficiency Score 32
Cycle 3 Standard Health Survey Date 01/17/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 32
Total Weighted Health Survey Score 19.333
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Shiloh Springs Care Center Inc

Owner Name Role Association Date
BERNSEN, KARA (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
25%
since 11/01/2007
BERNSEN, KARA (Individual) DIRECTOR since 11/01/2007
BERNSEN, KARA (Individual) OFFICER since 11/01/2007
BERNSEN, KENNETH (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
25%
since 11/01/2007
BERNSEN, KENNETH (Individual) DIRECTOR since 11/01/2007
BERNSEN, KENNETH (Individual) OFFICER since 11/01/2007
CAPITAL HEALTH SERVICES INC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 11/01/2007
HUFF, JOSHUA (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
25%
since 11/01/2007
HUFF, JOSHUA (Individual) DIRECTOR since 11/01/2007
HUFF, JOSHUA (Individual) OFFICER since 11/01/2007
MANNING, SARAH (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
25%
since 11/01/2007
MANNING, SARAH (Individual) DIRECTOR since 11/01/2007
MANNING, SARAH (Individual) OFFICER since 11/01/2007
PATRICK, APRIL (Individual) MANAGING EMPLOYEE since 01/07/2013
PATRICK, APRIL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/07/2013

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