Pennknoll Village - Everett Nursing Home
General Information
UPDATEFederal Provider Number
395422
Provider Name
PENNKNOLL VILLAGE
Provider Address
208 PENNKNOLL ROAD
EVERETT, PA 15537
EVERETT, PA 15537
Provider Phone Number
(814) 623-3200
Provider SSA County
100
Provider County Name
Bedford
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
133
Number of Residents in Certified Beds
125
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PENNKNOLL VILLAGE FACILITY OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1978-10-06
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
2
QM Rating Footnote
Staffing Rating
1
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
1.61880
Reported LPN Staffing Hours per Resident per Day
0.80800
Reported RN Staffing Hours per Resident per Day
0.53520
Reported Licensed Staffing Hours per Resident per Day
1.34320
Reported Total Nurse Staffing Hours per Resident per Day
2.96200
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08000
Expected CNA Staffing Hours per Resident per Day
2.34671
Expected LPN Staffing Hours per Resident per Day
0.67745
Expected RN Staffing Hours per Resident per Day
1.30864
Expected Total Nurse Staffing Hours per Resident per Day
4.33279
Adjusted CNA Staffing Hours per Resident per Day
1.69261
Adjusted LPN Staffing Hours per Resident per Day
0.98995
Adjusted RN Staffing Hours per Resident per Day
0.30559
Adjusted Total Nurse Staffing Hours per Resident per Day
2.75562
Cycle 1 Total Number of Health Deficiencies
24
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
15
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-06-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-07-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
60.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
15
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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