Mapleview Country Villa
775 South Street, Chardon, OH 44024


Mapleview Country Villa is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 366433. The address is 775 South Street, Chardon, OH 44024. The zip code is 44024. The phone number is 4402868176.


Mapleview Country Villa · 775 South Street, Chardon, OH 44024

Federal Provider Number 366433
Provider Name MAPLEVIEW COUNTRY VILLA
Address 775 SOUTH STREET
CHARDON, OH 44024
Phone Number 4402868176
SSA County Code 280
County Name Geauga
Ownership Type For profit - Corporation
Certified Beds 100
Certified Beds Residents 76
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name MAPLEVIEW OPERATING COMPANY LLC
Date First Approved to Provide Medicare Medicaid Services 08/30/2015
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 5
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 2.58158
Reported LPN Staffing Hours per Resident per Day 0.98158
Reported RN Staffing Hours per Resident per Day 1.31974
Reported Licensed Staffing Hours per Resident per Day 2.30132
Reported Total Nurse Staffing Hours per Resident per Day 4.8829
Reported Physical Therapist Staffing Hours per Resident Per Day 0.14474
Expected CNA Staffing Hours per Resident per Day 2.53209
Expected LPN Staffing Hours per Resident per Day 0.67098
Expected RN Staffing Hours per Resident per Day 1.14781
Expected Total Nurse Staffing Hours per Resident per Day 4.35087
Adjusted CNA Staffing Hours per Resident per Day 2.50166
Adjusted LPN Staffing Hours per Resident per Day 1.21422
Adjusted RN Staffing Hours per Resident per Day 0.85912
Adjusted Total Nurse Staffing Hours per Resident per Day 4.5238
Cycle 1 Total Number of Health Deficiencies 5
Cycle 1 Number of Standard Health Deficiencies 5
Cycle 1 Health Deficiency Score 32
Cycle 1 Standard Survey Health Date 11/03/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 32
Cycle 2 Total Number of Health Deficiencies 3
Cycle 2 Number of Complaint Health Deficiencies 3
Cycle 2 Health Deficiency Score 12
Cycle 2 Standard Health Survey Date 08/20/2015
Cycle 2 Total Health Score 12
Total Weighted Health Survey Score 24
Number of Facility Reported Incidents 1
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Mapleview Country Villa

Owner Name Role Association Date
BRUCE & MALKA DASKAL FAMILY 2008 DYNASTY TRUST (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2012
BRUCE & MALKA DASKAL FAMILY 2008 DYNASTY TRUST (Organization) 5% OR GREATER MORTGAGE INTEREST since 05/09/2014
DASKAL, BRUCE (Individual) DIRECTOR since 07/17/2012
DASKAL, BRUCE (Individual) MANAGING EMPLOYEE since 07/17/2012
DASKAL, BRUCE (Individual) OFFICER since 07/17/2012
DASKAL, SHARON (Individual) DIRECTOR since 07/17/2012
DMD MANAGEMENT INC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 07/17/2012
GOODWIN, DIANE (Individual) OFFICER since 07/17/2012
MAPLEVIEW HOLDING COMPANY LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 07/17/2012
RBS CITIZENS NA (Organization) 5% OR GREATER MORTGAGE INTEREST since 06/01/2015
SHARVIT, ELLAR (Individual) OFFICER since 07/17/2012
STUMP, BARRY (Individual) OFFICER since 07/17/2012
ZOOGNISCHT LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
96%
since 07/17/2012

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