Lebanon Valley Home The - Annville Nursing Home
General Information
UPDATEFederal Provider Number
395832
Provider Name
LEBANON VALLEY HOME THE
Provider Address
550 EAST MAIN STREET
ANNVILLE, PA 17003
ANNVILLE, PA 17003
Provider Phone Number
(717) 867-4467
Provider SSA County
460
Provider County Name
Lebanon
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
55
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UNITED CHURCH OF CHRIST HOMES
Date First Approved to Provide Medicare and Medicaid services
1990-09-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.61887
Reported LPN Staffing Hours per Resident per Day
0.50849
Reported RN Staffing Hours per Resident per Day
1.05660
Reported Licensed Staffing Hours per Resident per Day
1.56509
Reported Total Nurse Staffing Hours per Resident per Day
4.18396
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10472
Expected CNA Staffing Hours per Resident per Day
2.56360
Expected LPN Staffing Hours per Resident per Day
0.66745
Expected RN Staffing Hours per Resident per Day
1.15093
Expected Total Nurse Staffing Hours per Resident per Day
4.38198
Adjusted CNA Staffing Hours per Resident per Day
2.50660
Adjusted LPN Staffing Hours per Resident per Day
0.63233
Adjusted RN Staffing Hours per Resident per Day
0.68596
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84874
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2013-05-17
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
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
2012-04-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
3.33300
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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