Envoy Of Woodbridge, Llc - Woodbridge Nursing Home
General Information
UPDATEFederal Provider Number
495361
Provider Name
ENVOY OF WOODBRIDGE, LLC
Provider Address
14906 JEFFERSON DAVIS HIGHWAY
WOODBRIDGE, VA 22191
WOODBRIDGE, VA 22191
Provider Phone Number
(703) 491-6167
Provider SSA County
750
Provider County Name
Prince William
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
114
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ENVOY OF WOODBRIDGE, LLC
Date First Approved to Provide Medicare and Medicaid services
2002-07-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
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
2.10614
Reported LPN Staffing Hours per Resident per Day
0.91711
Reported RN Staffing Hours per Resident per Day
0.68509
Reported Licensed Staffing Hours per Resident per Day
1.60219
Reported Total Nurse Staffing Hours per Resident per Day
3.70834
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08026
Expected CNA Staffing Hours per Resident per Day
2.36876
Expected LPN Staffing Hours per Resident per Day
0.70307
Expected RN Staffing Hours per Resident per Day
1.26296
Expected Total Nurse Staffing Hours per Resident per Day
4.33478
Adjusted CNA Staffing Hours per Resident per Day
2.18166
Adjusted LPN Staffing Hours per Resident per Day
1.08269
Adjusted RN Staffing Hours per Resident per Day
0.40532
Adjusted Total Nurse Staffing Hours per Resident per Day
3.44838
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
116
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
116
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-11-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-11-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
86.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
15
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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