Envoy Of Williamsburg, Llc - Williamsburg Nursing Home
General Information
UPDATEFederal Provider Number
495235
Provider Name
ENVOY OF WILLIAMSBURG, LLC
Provider Address
1235 MT VERNON AVENUE
WILLIAMSBURG, VA 23185
WILLIAMSBURG, VA 23185
Provider Phone Number
(757) 229-4121
Provider SSA County
470
Provider County Name
James City
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
130
Number of Residents in Certified Beds
121
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ENVOY OF WILLIAMSBURG, LLC
Date First Approved to Provide Medicare and Medicaid services
1991-04-17
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
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
1.94711
Reported LPN Staffing Hours per Resident per Day
1.08802
Reported RN Staffing Hours per Resident per Day
0.57810
Reported Licensed Staffing Hours per Resident per Day
1.66612
Reported Total Nurse Staffing Hours per Resident per Day
3.61323
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09959
Expected CNA Staffing Hours per Resident per Day
2.26956
Expected LPN Staffing Hours per Resident per Day
0.67221
Expected RN Staffing Hours per Resident per Day
1.02450
Expected Total Nurse Staffing Hours per Resident per Day
3.96627
Adjusted CNA Staffing Hours per Resident per Day
2.10509
Adjusted LPN Staffing Hours per Resident per Day
1.34341
Adjusted RN Staffing Hours per Resident per Day
0.42163
Adjusted Total Nurse Staffing Hours per Resident per Day
3.67211
Cycle 1 Total Number of Health Deficiencies
29
Cycle 1 Number of Standard Health Deficiencies
21
Cycle 1 Number of Complaint Health Deficiencies
19
Cycle 1 Health Deficiency Score
168
Cycle 1 Standard Survey Health Date
2014-07-10
Cycle 1 Number of Health Revisits
4
Cycle 1 Health Revisit Score
143
Cycle 1 Total Health Score
311
Cycle 2 Total Number of Health Deficiencies
26
Cycle 2 Number of Standard Health Deficiencies
21
Cycle 2 Number of Complaint Health Deficiencies
16
Cycle 2 Health Deficiency Score
120
Cycle 2 Standard Health Survey Date
2014-01-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
120
Cycle 3 Total Number of Health Deficiencies
26
Cycle 3 Number of Standard Health Deficiencies
18
Cycle 3 Number of Complaint Health Deficiencies
16
Cycle 3 Health Deficiency Score
132
Cycle 3 Standard Health Survey Date
2013-02-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
132
Total Weighted Health Survey Score
217.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
22
Number of Fines
1
Total Amount of Fines in Dollars
87848
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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