Pavilion At St Luke Village, The - Hazleton Nursing Home

General Information

UPDATE
Federal Provider Number
395265
Provider Name
PAVILION AT ST LUKE VILLAGE, THE
Provider Address
1000 STACIE DRIVE
HAZLETON, PA 18201
Provider Phone Number
(570) 453-5100
Provider SSA County
480
Provider County Name
Luzerne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PAVILION AT ST. LUKE VILLAGE FACILITY OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1969-05-29
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.38000
Reported LPN Staffing Hours per Resident per Day
0.76565
Reported RN Staffing Hours per Resident per Day
0.42826
Reported Licensed Staffing Hours per Resident per Day
1.19391
Reported Total Nurse Staffing Hours per Resident per Day
3.57391
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04957
Expected CNA Staffing Hours per Resident per Day
2.48951
Expected LPN Staffing Hours per Resident per Day
0.64358
Expected RN Staffing Hours per Resident per Day
1.08321
Expected Total Nurse Staffing Hours per Resident per Day
4.21630
Adjusted CNA Staffing Hours per Resident per Day
2.34577
Adjusted LPN Staffing Hours per Resident per Day
0.98743
Adjusted RN Staffing Hours per Resident per Day
0.29541
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41676
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-10-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
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
28
Cycle 2 Standard Health Survey Date
2013-09-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-10-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
55.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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