Carleton Senior Care And Rehab - Wellsboro Nursing Home
General Information
UPDATEFederal Provider Number
395712
Provider Name
CARLETON SENIOR CARE AND REHAB
Provider Address
10 WEST AVENUE
WELLSBORO, PA 16901
WELLSBORO, PA 16901
Provider Phone Number
(570) 724-2631
Provider SSA County
710
Provider County Name
Tioga
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
26
Number of Residents in Certified Beds
23
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARLETON SENIOR CARE AND REHABILITATION CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1986-03-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.14348
Reported LPN Staffing Hours per Resident per Day
0.31087
Reported RN Staffing Hours per Resident per Day
1.40870
Reported Licensed Staffing Hours per Resident per Day
1.71957
Reported Total Nurse Staffing Hours per Resident per Day
3.86305
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05000
Expected CNA Staffing Hours per Resident per Day
2.50612
Expected LPN Staffing Hours per Resident per Day
0.61997
Expected RN Staffing Hours per Resident per Day
1.15082
Expected Total Nurse Staffing Hours per Resident per Day
4.27691
Adjusted CNA Staffing Hours per Resident per Day
2.09865
Adjusted LPN Staffing Hours per Resident per Day
0.41618
Adjusted RN Staffing Hours per Resident per Day
0.91464
Adjusted Total Nurse Staffing Hours per Resident per Day
3.64085
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-04-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-06-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-08-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
45.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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