Locust Grove Retirement Village - Mifflin Nursing Home
General Information
UPDATEFederal Provider Number
395350
Provider Name
LOCUST GROVE RETIREMENT VILLAGE
Provider Address
69 COTTAGE ROAD
MIFFLIN, PA 17058
MIFFLIN, PA 17058
Provider Phone Number
(717) 436-8921
Provider SSA County
410
Provider County Name
Juniata
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LOCUST GROVE FACILITY OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1976-05-12
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.76771
Reported LPN Staffing Hours per Resident per Day
0.80938
Reported RN Staffing Hours per Resident per Day
0.39844
Reported Licensed Staffing Hours per Resident per Day
1.20781
Reported Total Nurse Staffing Hours per Resident per Day
2.97553
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05938
Expected CNA Staffing Hours per Resident per Day
2.38186
Expected LPN Staffing Hours per Resident per Day
0.66514
Expected RN Staffing Hours per Resident per Day
1.20020
Expected Total Nurse Staffing Hours per Resident per Day
4.24720
Adjusted CNA Staffing Hours per Resident per Day
1.82103
Adjusted LPN Staffing Hours per Resident per Day
1.00999
Adjusted RN Staffing Hours per Resident per Day
0.24805
Adjusted Total Nurse Staffing Hours per Resident per Day
2.82399
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-02-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2014-03-27
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
38
Cycle 2 Total Health Score
114
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
28
Cycle 3 Standard Health Survey Date
2013-02-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
64.66700
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
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