Mercy Hospital Skilled Nursing Facility - Lackawanna Nursing Home
General Information
UPDATEFederal Provider Number
335308
Provider Name
MERCY HOSPITAL SKILLED NURSING FACILITY
Provider Address
55 MELROY AVENUE
LACKAWANNA, NY 14218
LACKAWANNA, NY 14218
Provider Phone Number
(716) 819-5300
Provider SSA County
240
Provider County Name
Erie
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
84
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
MERCY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1970-07-01
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
4
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.30179
Reported LPN Staffing Hours per Resident per Day
1.12024
Reported RN Staffing Hours per Resident per Day
0.67976
Reported Licensed Staffing Hours per Resident per Day
1.80000
Reported Total Nurse Staffing Hours per Resident per Day
4.10179
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06429
Expected CNA Staffing Hours per Resident per Day
2.72825
Expected LPN Staffing Hours per Resident per Day
0.62012
Expected RN Staffing Hours per Resident per Day
0.80442
Expected Total Nurse Staffing Hours per Resident per Day
4.15279
Adjusted CNA Staffing Hours per Resident per Day
2.07016
Adjusted LPN Staffing Hours per Resident per Day
1.49938
Adjusted RN Staffing Hours per Resident per Day
0.63140
Adjusted Total Nurse Staffing Hours per Resident per Day
3.98140
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-09-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
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
12
Cycle 3 Standard Health Survey Date
2012-09-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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