King Street Home Inc - Port Chester Nursing Home
General Information
UPDATEFederal Provider Number
335447
Provider Name
KING STREET HOME INC
Provider Address
787 KING STREET
PORT CHESTER, NY 10573
PORT CHESTER, NY 10573
Provider Phone Number
9149375800
Provider SSA County
800
Provider County Name
Westchester
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KING STREET HOME INC
Date First Approved to Provide Medicare and Medicaid services
1975-07-01
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
Partial
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.65400
Reported LPN Staffing Hours per Resident per Day
1.08267
Reported RN Staffing Hours per Resident per Day
0.62600
Reported Licensed Staffing Hours per Resident per Day
1.70867
Reported Total Nurse Staffing Hours per Resident per Day
4.36267
Reported Physical Therapist Staffing Hours per Resident Per Day
0.36933
Expected CNA Staffing Hours per Resident per Day
2.57376
Expected LPN Staffing Hours per Resident per Day
0.65248
Expected RN Staffing Hours per Resident per Day
1.11371
Expected Total Nurse Staffing Hours per Resident per Day
4.33995
Adjusted CNA Staffing Hours per Resident per Day
2.53020
Adjusted LPN Staffing Hours per Resident per Day
1.37724
Adjusted RN Staffing Hours per Resident per Day
0.41999
Adjusted Total Nurse Staffing Hours per Resident per Day
4.05200
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2014-02-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-01-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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
Nursiong Homes Nearby
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Tarrytown Hall Care Center
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