Manor At St Luke Village,the - Hazleton Nursing Home
General Information
UPDATEFederal Provider Number
395636
Provider Name
MANOR AT ST LUKE VILLAGE,THE
Provider Address
1711 EAST BROAD STREET
HAZLETON, PA 18201
HAZLETON, PA 18201
Provider Phone Number
(570) 453-5122
Provider SSA County
480
Provider County Name
Luzerne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR AT ST. LUKE VILLAGE FACILITY OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1984-04-02
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
2.06316
Reported LPN Staffing Hours per Resident per Day
0.92579
Reported RN Staffing Hours per Resident per Day
0.47789
Reported Licensed Staffing Hours per Resident per Day
1.40368
Reported Total Nurse Staffing Hours per Resident per Day
3.46684
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10842
Expected CNA Staffing Hours per Resident per Day
2.50918
Expected LPN Staffing Hours per Resident per Day
0.67713
Expected RN Staffing Hours per Resident per Day
1.17317
Expected Total Nurse Staffing Hours per Resident per Day
4.35948
Adjusted CNA Staffing Hours per Resident per Day
2.01754
Adjusted LPN Staffing Hours per Resident per Day
1.13480
Adjusted RN Staffing Hours per Resident per Day
0.30437
Adjusted Total Nurse Staffing Hours per Resident per Day
3.20554
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-04-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
50.66700
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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