Island Nursing And Rehabilitation Center Inc - Holtsville Nursing Home
General Information
UPDATEFederal Provider Number
335835
Provider Name
ISLAND NURSING AND REHABILITATION CENTER INC
Provider Address
5537 EXPRESSWAY DRIVE NORTH
HOLTSVILLE, NY 11742
HOLTSVILLE, NY 11742
Provider Phone Number
(631) 758-3336
Provider SSA County
700
Provider County Name
Suffolk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
111
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ISLAND REHABILITATION AND NURSING CENTER INC
Date First Approved to Provide Medicare and Medicaid services
2001-11-30
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
3
Overall Rating Footnote
Health Inspection Rating
2
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
2.34009
Reported LPN Staffing Hours per Resident per Day
1.18919
Reported RN Staffing Hours per Resident per Day
0.59505
Reported Licensed Staffing Hours per Resident per Day
1.78423
Reported Total Nurse Staffing Hours per Resident per Day
4.12433
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14459
Expected CNA Staffing Hours per Resident per Day
2.53716
Expected LPN Staffing Hours per Resident per Day
0.69714
Expected RN Staffing Hours per Resident per Day
1.11370
Expected Total Nurse Staffing Hours per Resident per Day
4.34800
Adjusted CNA Staffing Hours per Resident per Day
2.26312
Adjusted LPN Staffing Hours per Resident per Day
1.41581
Adjusted RN Staffing Hours per Resident per Day
0.39923
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82354
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-05-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-05-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-05-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
31.33300
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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