Manor At Susquehanna Village,the - Millersburg Nursing Home
General Information
UPDATEFederal Provider Number
395428
Provider Name
MANOR AT SUSQUEHANNA VILLAGE,THE
Provider Address
990 MEDICAL ROAD
MILLERSBURG, PA 17061
MILLERSBURG, PA 17061
Provider Phone Number
(717) 692-4751
Provider SSA County
280
Provider County Name
Dauphin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
194
Number of Residents in Certified Beds
188
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SUSQUEHANNA VILLAGE FACILITY OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1979-07-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
1.98457
Reported LPN Staffing Hours per Resident per Day
0.76436
Reported RN Staffing Hours per Resident per Day
0.45186
Reported Licensed Staffing Hours per Resident per Day
1.21622
Reported Total Nurse Staffing Hours per Resident per Day
3.20079
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05771
Expected CNA Staffing Hours per Resident per Day
2.46868
Expected LPN Staffing Hours per Resident per Day
0.65592
Expected RN Staffing Hours per Resident per Day
1.17346
Expected Total Nurse Staffing Hours per Resident per Day
4.29806
Adjusted CNA Staffing Hours per Resident per Day
1.97252
Adjusted LPN Staffing Hours per Resident per Day
0.96722
Adjusted RN Staffing Hours per Resident per Day
0.28772
Adjusted Total Nurse Staffing Hours per Resident per Day
3.00183
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
80
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
80
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
40
Cycle 2 Standard Health Survey Date
2013-05-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-04-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
60.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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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