Lake Prince Woods, Inc - Suffolk Nursing Home
General Information
UPDATEFederal Provider Number
495366
Provider Name
LAKE PRINCE WOODS, INC
Provider Address
100 ANNA GOODE WAY
SUFFOLK, VA 23434
SUFFOLK, VA 23434
Provider Phone Number
(757) 923-5500
Provider SSA County
892
Provider County Name
Suffolk City
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LAKE PRINCE CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
2003-01-14
Continuing Care Retirement Community
Y
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.43065
Reported LPN Staffing Hours per Resident per Day
1.12903
Reported RN Staffing Hours per Resident per Day
1.23226
Reported Licensed Staffing Hours per Resident per Day
2.36129
Reported Total Nurse Staffing Hours per Resident per Day
4.79194
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16613
Expected CNA Staffing Hours per Resident per Day
2.49551
Expected LPN Staffing Hours per Resident per Day
0.60191
Expected RN Staffing Hours per Resident per Day
1.08595
Expected Total Nurse Staffing Hours per Resident per Day
4.18337
Adjusted CNA Staffing Hours per Resident per Day
2.38992
Adjusted LPN Staffing Hours per Resident per Day
1.55687
Adjusted RN Staffing Hours per Resident per Day
0.84787
Adjusted Total Nurse Staffing Hours per Resident per Day
4.61729
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
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
12
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
108
Cycle 2 Standard Health Survey Date
2014-02-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
108
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
2013-01-11
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
42.00000
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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