Cooper River West - Pennsauken Nursing Home
General Information
UPDATEFederal Provider Number
315225
Provider Name
COOPER RIVER WEST
Provider Address
5101 NORTH PARK DRIVE
PENNSAUKEN, NJ 8109
PENNSAUKEN, NJ 8109
Provider Phone Number
8566658844
Provider SSA County
160
Provider County Name
Camden
Ownership Type
For profit - Corporation
Number of Certified Beds
180
Number of Residents in Certified Beds
162
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
5101 NORTH PARK DRIVE OPERATIONS
Date First Approved to Provide Medicare and Medicaid services
1986-03-13
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
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.87685
Reported LPN Staffing Hours per Resident per Day
0.61327
Reported RN Staffing Hours per Resident per Day
0.70340
Reported Licensed Staffing Hours per Resident per Day
1.31667
Reported Total Nurse Staffing Hours per Resident per Day
3.19352
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04660
Expected CNA Staffing Hours per Resident per Day
2.33876
Expected LPN Staffing Hours per Resident per Day
0.69840
Expected RN Staffing Hours per Resident per Day
1.15435
Expected Total Nurse Staffing Hours per Resident per Day
4.19151
Adjusted CNA Staffing Hours per Resident per Day
1.96909
Adjusted LPN Staffing Hours per Resident per Day
0.72882
Adjusted RN Staffing Hours per Resident per Day
0.45530
Adjusted Total Nurse Staffing Hours per Resident per Day
3.07115
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-05-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-06-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-05-17
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
78.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
32
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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