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401 Fountain Street
Hicksville, OH 43526
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| Type of Ownership | Non profit - Corporation |
| Participates in Medicare? | Yes |
| Participates in Medicaid? | Yes |
| Certified Beds | 63 |
| Continuing Care? | No |
| Resident Council? | Yes |
| Family Council? | No |
| Multi-Home Chain? | No |
| Located in a Hospital? | No |
| Special Focus Facility? | No |
View: Health Inspections | Quality Measures | Staffing | Fire Inspections
| Date of last standard health inspection: | 06/19/2011 |
| Quality Indicator Survey | No |
| Dates of Complaint Investigations: | 04/01/2011 - 03/31/2012 |
| Total number of Health Deficiencies for this nursing home: | 0 |
| Average number of Health Deficiencies in OH: | 2 |
| Average number of Health Deficiencies in US: | 3 |
| Range of Health Deficiencies in OH: | 0 - 12 |
Environmental Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | 00/01/2009 | 01/05/2010 | 1 | Many |
Quality Care Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Ensure services provided by the nursing facility meet professional standards of quality. | 00/01/2009 | 01/05/2010 | 2 | Few |
Resident Assessment Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | 03/00/2008 | 00/05/2010 | 2 | Few |
Quality Care Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Use a registered nurse at least 8 hours a day, 7 days a week. | 00/06/2004 | 00/01/2005 | 1 | Many |
Information comes from data that the nursing home reports to its state agency. It contains the nursing home staffing hours for a two-week period prior to the time of the state inspection. CMS receives this data and converts it into the number of staff hours per resident per day.
| National Average | Average in OH | Golden Living Center, Asheville | |
| RN Staff Only1 | N/A | N/A | 3 out of 5 stars |
| Total Number of Residents | 85 | 80 | 54 |
|
Total, Licensed Nurse Staff Hours per Resident per Day |
15 hours 26 minutes | 7 hours 50 minutes | 1 hour 15 minutes |
|
RN Hours per Resident per Day |
14 hours 37 minutes | 6 hours 57 minutes | 27 minutes |
|
LPN/LVN Hours per Resident per Day |
14 hours 52 minutes | 7 hours 10 minutes | 48 minutes |
|
CNA Hours per Resident per Day |
16 hours 21 minutes | 8 hours 36 minutes | 2 hours 10 minutes |
1 The star rating a nursing home received for the information it provided about its Registered Nurse (RN) staffing. RNs have between 2 and 6 years of education.
Information comes from data that the nursing home reports to its state agency. It contains the nursing home staffing hours for a two-week period prior to the time of the state inspection. CMS receives this data and converts it into the number of staff hours per resident per day.
Lists the fire safety requirements that the nursing home failed to meet. Fire safety results are not included in the nursing home's Overall Rating.
| Automatic Sprinkler Systems in all required areas | Yes |
| Date of last standard fire safety inspection: | 06/17/2011 |
| Dates of Complaint Investigations: | 04/01/2011 - 03/31/2012 |
| Total number of Fire Safety Deficiencies for this nursing home: | 0 |
| Average number of Fire Safety Deficiencies in OH: | 5 |
| Average number of Fire Safety Deficiencies in US: | 2 |
| Range of Fire Safety Deficiencies in OH: | 0 - 7 |
Building Service Equipment Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Properly protected cooking facilities. | 03/01/2008 | 01/05/2010 | 2 | Few |
Corridor Walls and Doors Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Signs that state that exit doors are to be kept closed. | 03/01/2008 | 01/05/2010 | 2 | Some |
Exits and Egress Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Exits that are accessible at all times. | 03/01/2008 | 01/05/2010 | 2 | Some |
Hazardous Area Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. | 03/01/2008 | 01/05/2010 | 2 | Many |
Medical Gases and Anesthetizing Areas Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Proper fire barriers, ventilation and signs for the transfilling of oxygen. | 03/01/2008 | 01/05/2010 | 2 | Many |
Smoke Compartmentation and Control Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Walls that prevent smoke from passing through and would resist fire for at least one hour. | 03/01/2008 | 01/05/2010 | 2 | Many |
Automatic Sprinkler Systems Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Automatic sprinkler systems that have been maintained in working order. | 02/09/2008 | 00/05/2010 | 2 | Some |
| Portable fire extinguishers. | 02/09/2008 | 00/05/2010 | 2 | Many |
Emergency Plans and Fire Drills Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Record of quarterly fire drills for each shift under varying conditions. | 02/09/2008 | 00/05/2010 | 1 | Many |
Illumination and Emergency Power Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Emergency lighting that can last at least 1 1/2 hours. | 02/09/2008 | 00/05/2010 | 2 | Many |
Automatic Sprinkler Systems Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Automatic sprinkler systems that have been maintained in working order. | 01/07/2006 | 02/05/2007 | 2 | Some |
Illumination and Emergency Power Deficiencies |
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| Deficiency | Inspection Date | Correction Date | Level of Harm | Residents Affected |
| Emergency lighting that can last at least 1 1/2 hours. | 01/07/2006 | 02/05/2007 | 2 | Some |