Helen Hayes Hospital Residential Health Care Fac - West Haverstraw Nursing Home
General Information
UPDATEFederal Provider Number
335823
Provider Name
HELEN HAYES HOSPITAL RESIDENTIAL HEALTH CARE FAC
Provider Address
51 N RT 9W
WEST HAVERSTRAW, NY 10993
WEST HAVERSTRAW, NY 10993
Provider Phone Number
(845) 786-4000
Provider SSA County
620
Provider County Name
Rockland
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
25
Number of Residents in Certified Beds
21
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
NYS OFFICE OF MENTAL HEALTH
Date First Approved to Provide Medicare and Medicaid services
2000-06-21
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.85714
Reported LPN Staffing Hours per Resident per Day
0.13571
Reported RN Staffing Hours per Resident per Day
3.67143
Reported Licensed Staffing Hours per Resident per Day
3.80714
Reported Total Nurse Staffing Hours per Resident per Day
6.66428
Reported Physical Therapist Staffing Hours per Resident Per Day
0.78810
Expected CNA Staffing Hours per Resident per Day
2.18328
Expected LPN Staffing Hours per Resident per Day
0.86277
Expected RN Staffing Hours per Resident per Day
2.09363
Expected Total Nurse Staffing Hours per Resident per Day
5.13968
Adjusted CNA Staffing Hours per Resident per Day
3.21103
Adjusted LPN Staffing Hours per Resident per Day
0.13055
Adjusted RN Staffing Hours per Resident per Day
1.31031
Adjusted Total Nurse Staffing Hours per Resident per Day
5.22660
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-10-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-09-26
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
5.33300
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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