Mercy Living Center - Tupper Lake Nursing Home
General Information
UPDATEFederal Provider Number
335220
Provider Name
MERCY LIVING CENTER
Provider Address
114 WAWBEEK AVE
TUPPER LAKE, NY 12986
TUPPER LAKE, NY 12986
Provider Phone Number
(518) 359-3355
Provider SSA County
270
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
ADIRONDACK MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
1967-05-24
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.40100
Reported LPN Staffing Hours per Resident per Day
1.00000
Reported RN Staffing Hours per Resident per Day
0.99500
Reported Licensed Staffing Hours per Resident per Day
1.99500
Reported Total Nurse Staffing Hours per Resident per Day
4.39600
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08100
Expected CNA Staffing Hours per Resident per Day
2.35078
Expected LPN Staffing Hours per Resident per Day
0.63082
Expected RN Staffing Hours per Resident per Day
1.03591
Expected Total Nurse Staffing Hours per Resident per Day
4.01752
Adjusted CNA Staffing Hours per Resident per Day
2.50612
Adjusted LPN Staffing Hours per Resident per Day
1.31574
Adjusted RN Staffing Hours per Resident per Day
0.71769
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41065
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-08-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-07-31
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
20.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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