Church Of God Home, Inc - Carlisle Nursing Home
General Information
UPDATEFederal Provider Number
395784
Provider Name
CHURCH OF GOD HOME, INC
Provider Address
801 N. HANOVER STREET
CARLISLE, PA 17013
CARLISLE, PA 17013
Provider Phone Number
(717) 249-5322
Provider SSA County
270
Provider County Name
Cumberland
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
109
Number of Residents in Certified Beds
105
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHURCH OF GOD HOME INC
Date First Approved to Provide Medicare and Medicaid services
1989-04-01
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.60905
Reported LPN Staffing Hours per Resident per Day
0.95667
Reported RN Staffing Hours per Resident per Day
0.57952
Reported Licensed Staffing Hours per Resident per Day
1.53619
Reported Total Nurse Staffing Hours per Resident per Day
4.14524
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06048
Expected CNA Staffing Hours per Resident per Day
2.66694
Expected LPN Staffing Hours per Resident per Day
0.63237
Expected RN Staffing Hours per Resident per Day
1.02735
Expected Total Nurse Staffing Hours per Resident per Day
4.32666
Adjusted CNA Staffing Hours per Resident per Day
2.40044
Adjusted LPN Staffing Hours per Resident per Day
1.25566
Adjusted RN Staffing Hours per Resident per Day
0.42149
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86188
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
14.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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