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Petersburg Medical Center Ltc - Petersburg Nursing Home

General Information

UPDATE
Federal Provider Number
25019
Provider Name
PETERSBURG MEDICAL CENTER LTC
Provider Address
P.O. BOX 589
PETERSBURG, AK 99833
Provider Phone Number
9077724291
Provider SSA County
280
Provider County Name
Petersburg
Ownership Type
Government - City
Number of Certified Beds
15
Number of Residents in Certified Beds
15
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
THE PETERSBURG MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
1981-01-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
4.67667
Reported LPN Staffing Hours per Resident per Day
0.75667
Reported RN Staffing Hours per Resident per Day
2.12000
Reported Licensed Staffing Hours per Resident per Day
2.87667
Reported Total Nurse Staffing Hours per Resident per Day
7.55334
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03000
Expected CNA Staffing Hours per Resident per Day
2.26516
Expected LPN Staffing Hours per Resident per Day
0.70329
Expected RN Staffing Hours per Resident per Day
0.96080
Expected Total Nurse Staffing Hours per Resident per Day
3.92925
Adjusted CNA Staffing Hours per Resident per Day
5.06594
Adjusted LPN Staffing Hours per Resident per Day
0.89299
Adjusted RN Staffing Hours per Resident per Day
1.64869
Adjusted Total Nurse Staffing Hours per Resident per Day
7.74875
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-10-25
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
72.66700
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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