Lakeside Health And Rehabilitation Center - Dallas Nursing Home
General Information
UPDATEFederal Provider Number
395730
Provider Name
LAKESIDE HEALTH AND REHABILITATION CENTER
Provider Address
245 OLD LAKE ROAD
DALLAS, PA 18612
DALLAS, PA 18612
Provider Phone Number
(570) 639-1885
Provider SSA County
480
Provider County Name
Luzerne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
31
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RELIANT LAKESIDE HOLDINGS, LLC
Date First Approved to Provide Medicare and Medicaid services
1987-06-01
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
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.42143
Reported LPN Staffing Hours per Resident per Day
0.73036
Reported RN Staffing Hours per Resident per Day
1.34821
Reported Licensed Staffing Hours per Resident per Day
2.07857
Reported Total Nurse Staffing Hours per Resident per Day
4.50000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03750
Expected CNA Staffing Hours per Resident per Day
2.64856
Expected LPN Staffing Hours per Resident per Day
0.76111
Expected RN Staffing Hours per Resident per Day
1.33422
Expected Total Nurse Staffing Hours per Resident per Day
4.74389
Adjusted CNA Staffing Hours per Resident per Day
2.24328
Adjusted LPN Staffing Hours per Resident per Day
0.79647
Adjusted RN Staffing Hours per Resident per Day
0.75504
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82366
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
2015-02-05
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
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2014-01-08
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
46
Cycle 2 Total Health Score
138
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
2013-02-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
53.33300
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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