Carthage Area Hospital S N F - Carthage Nursing Home
General Information
UPDATEFederal Provider Number
335453
Provider Name
CARTHAGE AREA HOSPITAL S N F
Provider Address
1001 WEST STREET ROAD
CARTHAGE, NY 13619
CARTHAGE, NY 13619
Provider Phone Number
(315) 493-1000
Provider SSA County
330
Provider County Name
Jefferson
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
30
Number of Residents in Certified Beds
30
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
CARTHAGE AREA HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1976-06-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.46000
Reported LPN Staffing Hours per Resident per Day
1.06667
Reported RN Staffing Hours per Resident per Day
0.36167
Reported Licensed Staffing Hours per Resident per Day
1.42833
Reported Total Nurse Staffing Hours per Resident per Day
3.88834
Reported Physical Therapist Staffing Hours per Resident Per Day
0.38167
Expected CNA Staffing Hours per Resident per Day
2.36678
Expected LPN Staffing Hours per Resident per Day
0.60607
Expected RN Staffing Hours per Resident per Day
0.85589
Expected Total Nurse Staffing Hours per Resident per Day
3.82873
Adjusted CNA Staffing Hours per Resident per Day
2.55035
Adjusted LPN Staffing Hours per Resident per Day
1.46079
Adjusted RN Staffing Hours per Resident per Day
0.31574
Adjusted Total Nurse Staffing Hours per Resident per Day
4.09366
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-07-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-05-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
0
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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