Lakeside At Willow Valley - Willow Street Nursing Home
General Information
UPDATEFederal Provider Number
395771
Provider Name
LAKESIDE AT WILLOW VALLEY
Provider Address
300 WILLOW VALLEY LAKES DRIVE
WILLOW STREET, PA 17584
WILLOW STREET, PA 17584
Provider Phone Number
(717) 464-9542
Provider SSA County
440
Provider County Name
Lancaster
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
76
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
WILLOW VALLEY COMMUNITIES
Date First Approved to Provide Medicare and Medicaid services
1989-01-01
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
4
Health Inspection Rating Footnote
QM Rating
4
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
2.49605
Reported LPN Staffing Hours per Resident per Day
0.99671
Reported RN Staffing Hours per Resident per Day
0.58289
Reported Licensed Staffing Hours per Resident per Day
1.57961
Reported Total Nurse Staffing Hours per Resident per Day
4.07565
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10921
Expected CNA Staffing Hours per Resident per Day
2.44947
Expected LPN Staffing Hours per Resident per Day
0.60979
Expected RN Staffing Hours per Resident per Day
0.93695
Expected Total Nurse Staffing Hours per Resident per Day
3.99621
Adjusted CNA Staffing Hours per Resident per Day
2.50036
Adjusted LPN Staffing Hours per Resident per Day
1.35665
Adjusted RN Staffing Hours per Resident per Day
0.46485
Adjusted Total Nurse Staffing Hours per Resident per Day
4.11103
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
12
Cycle 1 Standard Survey Health Date
2015-03-23
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2014-04-07
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-02-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
8.66700
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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