Masonic Village At Sewickley - Sewickley Nursing Home
General Information
UPDATEFederal Provider Number
395638
Provider Name
MASONIC VILLAGE AT SEWICKLEY
Provider Address
1000 MASONIC DRIVE
SEWICKLEY, PA 15143
SEWICKLEY, PA 15143
Provider Phone Number
(412) 741-1400
Provider SSA County
10
Provider County Name
Allegheny
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
128
Number of Residents in Certified Beds
124
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MASONIC VILLAGES OF THE GRAND LODGE OF PENNSYLVANIA
Date First Approved to Provide Medicare and Medicaid services
1984-03-09
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.80766
Reported LPN Staffing Hours per Resident per Day
0.72460
Reported RN Staffing Hours per Resident per Day
0.91250
Reported Licensed Staffing Hours per Resident per Day
1.63710
Reported Total Nurse Staffing Hours per Resident per Day
4.44476
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09234
Expected CNA Staffing Hours per Resident per Day
2.61468
Expected LPN Staffing Hours per Resident per Day
0.65336
Expected RN Staffing Hours per Resident per Day
0.96067
Expected Total Nurse Staffing Hours per Resident per Day
4.22872
Adjusted CNA Staffing Hours per Resident per Day
2.63479
Adjusted LPN Staffing Hours per Resident per Day
0.92050
Adjusted RN Staffing Hours per Resident per Day
0.70973
Adjusted Total Nurse Staffing Hours per Resident per Day
4.23684
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-09-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-08-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-09-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
17.33300
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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