Otterbein Monclova
5069 Otterbein Way, Monclova, OH 43542


Otterbein Monclova is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 366361. The address is 5069 Otterbein Way, Monclova, OH 43542. The zip code is 43542. The phone number is 4198780550.


Otterbein Monclova · 5069 Otterbein Way, Monclova, OH 43542

Federal Provider Number 366361
Provider Name OTTERBEIN MONCLOVA
Address 5069 OTTERBEIN WAY
MONCLOVA, OH 43542
Phone Number 4198780550
SSA County Code 490
County Name Lucas
Ownership Type Non profit - Corporation
Certified Beds 50
Certified Beds Residents 46
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name Legal Business Name Not Available
Date First Approved to Provide Medicare Medicaid Services 05/20/2008
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 None
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 3
Health Inspection Rating 3
Quality Measure Rating 2
Staffing Rating 3
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 4.32935
Reported LPN Staffing Hours per Resident per Day 0.64348
Reported RN Staffing Hours per Resident per Day 0.38261
Reported Licensed Staffing Hours per Resident per Day 1.02609
Reported Total Nurse Staffing Hours per Resident per Day 5.35544
Reported Physical Therapist Staffing Hours per Resident Per Day 0.01848
Expected CNA Staffing Hours per Resident per Day 2.52141
Expected LPN Staffing Hours per Resident per Day 0.6858
Expected RN Staffing Hours per Resident per Day 1.22431
Expected Total Nurse Staffing Hours per Resident per Day 4.43153
Adjusted CNA Staffing Hours per Resident per Day 4.21309
Adjusted LPN Staffing Hours per Resident per Day 0.77878
Adjusted RN Staffing Hours per Resident per Day 0.23351
Adjusted Total Nurse Staffing Hours per Resident per Day 4.87129
Cycle 1 Total Number of Health Deficiencies 4
Cycle 1 Number of Standard Health Deficiencies 4
Cycle 1 Health Deficiency Score 16
Cycle 1 Standard Survey Health Date 08/18/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 16
Cycle 2 Total Number of Health Deficiencies 2
Cycle 2 Number of Standard Health Deficiencies 1
Cycle 2 Number of Complaint Health Deficiencies 1
Cycle 2 Health Deficiency Score 12
Cycle 2 Standard Health Survey Date 07/23/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 12
Cycle 3 Total Number of Health Deficiencies 4
Cycle 3 Number of Standard Health Deficiencies 2
Cycle 3 Number of Complaint Health Deficiencies 2
Cycle 3 Health Deficiency Score 87
Cycle 3 Standard Health Survey Date 04/03/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 87
Total Weighted Health Survey Score 26.5
Number of Substantiated Complaints 4
Number of Fines 1
Total Amount of Fines in Dollars $28113.00
Total Number of Penalties 1
Processing Date 08/01/2017

Owner or Manager · Otterbein Monclova

Owner Name Role Association Date
() Ownership Data Not Available

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