Manor At Perry Village, The - New Bloomfield Nursing Home
General Information
UPDATEFederal Provider Number
395426
Provider Name
MANOR AT PERRY VILLAGE, THE
Provider Address
213 EAST MAIN STREET
NEW BLOOMFIELD, PA 17068
NEW BLOOMFIELD, PA 17068
Provider Phone Number
(717) 582-4346
Provider SSA County
610
Provider County Name
Perry
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
123
Number of Residents in Certified Beds
108
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PERRY VILLAGE FACILITY OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1979-01-18
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
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.88148
Reported LPN Staffing Hours per Resident per Day
0.93750
Reported RN Staffing Hours per Resident per Day
0.46019
Reported Licensed Staffing Hours per Resident per Day
1.39769
Reported Total Nurse Staffing Hours per Resident per Day
3.27917
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05278
Expected CNA Staffing Hours per Resident per Day
2.31104
Expected LPN Staffing Hours per Resident per Day
0.67031
Expected RN Staffing Hours per Resident per Day
1.14808
Expected Total Nurse Staffing Hours per Resident per Day
4.12942
Adjusted CNA Staffing Hours per Resident per Day
1.99763
Adjusted LPN Staffing Hours per Resident per Day
1.16084
Adjusted RN Staffing Hours per Resident per Day
0.29950
Adjusted Total Nurse Staffing Hours per Resident per Day
3.20093
Cycle 1 Total Number of Health Deficiencies
23
Cycle 1 Number of Standard Health Deficiencies
21
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
120
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
120
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-06-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
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
12
Cycle 3 Standard Health Survey Date
2012-05-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
71.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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