Our Ladys Residence - Pleasantville Nursing Home
General Information
UPDATEFederal Provider Number
315054
Provider Name
OUR LADYS RESIDENCE
Provider Address
1100 CLEMATIS AVE
PLEASANTVILLE, NJ 8232
PLEASANTVILLE, NJ 8232
Provider Phone Number
(609) 646-2450
Provider SSA County
0
Provider County Name
Atlantic
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
214
Number of Residents in Certified Beds
153
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
OUR LADY'S RESIDENCE
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
3
Health Inspection Rating Footnote
QM Rating
3
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
2.59477
Reported LPN Staffing Hours per Resident per Day
0.91993
Reported RN Staffing Hours per Resident per Day
0.77941
Reported Licensed Staffing Hours per Resident per Day
1.69935
Reported Total Nurse Staffing Hours per Resident per Day
4.29411
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08856
Expected CNA Staffing Hours per Resident per Day
2.37858
Expected LPN Staffing Hours per Resident per Day
0.63770
Expected RN Staffing Hours per Resident per Day
1.10696
Expected Total Nurse Staffing Hours per Resident per Day
4.12324
Adjusted CNA Staffing Hours per Resident per Day
2.67671
Adjusted LPN Staffing Hours per Resident per Day
1.19734
Adjusted RN Staffing Hours per Resident per Day
0.52610
Adjusted Total Nurse Staffing Hours per Resident per Day
4.19794
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-11-20
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
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-09-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
22.00000
Number of Facility Reported Incidents
2
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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