Providence Rest Inc - Bronx Nursing Home
General Information
UPDATEFederal Provider Number
335583
Provider Name
PROVIDENCE REST INC
Provider Address
3304 WATERBURY AVENUE
BRONX, NY 10465
BRONX, NY 10465
Provider Phone Number
(718) 931-3000
Provider SSA County
20
Provider County Name
Bronx
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
200
Number of Residents in Certified Beds
169
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PROVIDENCE REST
Date First Approved to Provide Medicare and Medicaid services
1976-12-01
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
4
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
2.40828
Reported LPN Staffing Hours per Resident per Day
0.89852
Reported RN Staffing Hours per Resident per Day
0.47219
Reported Licensed Staffing Hours per Resident per Day
1.37071
Reported Total Nurse Staffing Hours per Resident per Day
3.77899
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09586
Expected CNA Staffing Hours per Resident per Day
2.48761
Expected LPN Staffing Hours per Resident per Day
0.66164
Expected RN Staffing Hours per Resident per Day
1.13753
Expected Total Nurse Staffing Hours per Resident per Day
4.28678
Adjusted CNA Staffing Hours per Resident per Day
2.37546
Adjusted LPN Staffing Hours per Resident per Day
1.12715
Adjusted RN Staffing Hours per Resident per Day
0.31016
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55342
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-09-23
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-08-30
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
4
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-08-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
9.33300
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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