New Gouverneur Hospital S N F - New York Nursing Home
General Information
UPDATEFederal Provider Number
335461
Provider Name
NEW GOUVERNEUR HOSPITAL S N F
Provider Address
227 MADISON STREET
NEW YORK, NY 10002
NEW YORK, NY 10002
Provider Phone Number
(212) 441-5000
Provider SSA County
420
Provider County Name
New York
Provider Website
Provider Description
Ownership Type
Government - City
Number of Certified Beds
210
Number of Residents in Certified Beds
202
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NEW YORK CITY HEALTH & HOSPITALS CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1975-07-15
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
4
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
2.82277
Reported LPN Staffing Hours per Resident per Day
0.65569
Reported RN Staffing Hours per Resident per Day
1.21089
Reported Licensed Staffing Hours per Resident per Day
1.86658
Reported Total Nurse Staffing Hours per Resident per Day
4.68935
Reported Physical Therapist Staffing Hours per Resident Per Day
0.20124
Expected CNA Staffing Hours per Resident per Day
2.44728
Expected LPN Staffing Hours per Resident per Day
0.71187
Expected RN Staffing Hours per Resident per Day
1.19277
Expected Total Nurse Staffing Hours per Resident per Day
4.35193
Adjusted CNA Staffing Hours per Resident per Day
2.83017
Adjusted LPN Staffing Hours per Resident per Day
0.76449
Adjusted RN Staffing Hours per Resident per Day
0.75855
Adjusted Total Nurse Staffing Hours per Resident per Day
4.34343
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-12-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-12-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
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
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
5980
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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