Elderwood At Waverly - Waverly Nursing Home
General Information
UPDATEFederal Provider Number
335346
Provider Name
ELDERWOOD AT WAVERLY
Provider Address
37 NORTH CHEMUNG STREET
WAVERLY, NY 14892
WAVERLY, NY 14892
Provider Phone Number
(607) 565-2861
Provider SSA County
720
Provider County Name
Tioga
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
200
Number of Residents in Certified Beds
179
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
37 NORTH CHEMUNG STREET OPERATING COMPANY, LLC
Date First Approved to Provide Medicare and Medicaid services
1971-12-10
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.03520
Reported LPN Staffing Hours per Resident per Day
0.96760
Reported RN Staffing Hours per Resident per Day
0.66955
Reported Licensed Staffing Hours per Resident per Day
1.63715
Reported Total Nurse Staffing Hours per Resident per Day
3.67235
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09553
Expected CNA Staffing Hours per Resident per Day
2.46533
Expected LPN Staffing Hours per Resident per Day
0.67814
Expected RN Staffing Hours per Resident per Day
1.18365
Expected Total Nurse Staffing Hours per Resident per Day
4.32712
Adjusted CNA Staffing Hours per Resident per Day
2.02560
Adjusted LPN Staffing Hours per Resident per Day
1.18428
Adjusted RN Staffing Hours per Resident per Day
0.42267
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42096
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
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
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
0
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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