Edna Tina Wilson Living Center - Rochester Nursing Home

General Information

UPDATE
Federal Provider Number
335769
Provider Name
EDNA TINA WILSON LIVING CENTER
Provider Address
700 ISLAND COTTAGE ROAD
ROCHESTER, NY 14612
Provider Phone Number
5853686100
Provider SSA County
370
Provider County Name
Monroe
Ownership Type
Non profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
118
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTH PARK NURSING HOME
Date First Approved to Provide Medicare and Medicaid services
1993-12-07
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.21102
Reported LPN Staffing Hours per Resident per Day
1.10212
Reported RN Staffing Hours per Resident per Day
0.72585
Reported Licensed Staffing Hours per Resident per Day
1.82797
Reported Total Nurse Staffing Hours per Resident per Day
4.03899
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04364
Expected CNA Staffing Hours per Resident per Day
2.54765
Expected LPN Staffing Hours per Resident per Day
0.62037
Expected RN Staffing Hours per Resident per Day
0.89730
Expected Total Nurse Staffing Hours per Resident per Day
4.06532
Adjusted CNA Staffing Hours per Resident per Day
2.12948
Adjusted LPN Staffing Hours per Resident per Day
1.47454
Adjusted RN Staffing Hours per Resident per Day
0.60443
Adjusted Total Nurse Staffing Hours per Resident per Day
4.00479
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
165
Cycle 2 Standard Health Survey Date
2014-01-24
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-12-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
64.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
4550
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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