Millcreek Manor - Erie Nursing Home

General Information

UPDATE
Federal Provider Number
396072
Provider Name
MILLCREEK MANOR
Provider Address
5515 PEACH STREET
ERIE, PA 16509
Provider Phone Number
8148687395
Provider SSA County
320
Provider County Name
Erie
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MILLCREEK MANOR
Date First Approved to Provide Medicare and Medicaid services
2000-07-24
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.22200
Reported LPN Staffing Hours per Resident per Day
1.42800
Reported RN Staffing Hours per Resident per Day
0.84800
Reported Licensed Staffing Hours per Resident per Day
2.27600
Reported Total Nurse Staffing Hours per Resident per Day
4.49800
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.42838
Expected LPN Staffing Hours per Resident per Day
0.66695
Expected RN Staffing Hours per Resident per Day
1.25940
Expected Total Nurse Staffing Hours per Resident per Day
4.35473
Adjusted CNA Staffing Hours per Resident per Day
2.24517
Adjusted LPN Staffing Hours per Resident per Day
1.77710
Adjusted RN Staffing Hours per Resident per Day
0.50312
Adjusted Total Nurse Staffing Hours per Resident per Day
4.16352
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-10-16
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
36
Cycle 3 Standard Health Survey Date
2012-11-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
23.33300
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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