Saint Mary's Villa Nursing Hom - Moscow Nursing Home
General Information
UPDATEFederal Provider Number
395104
Provider Name
SAINT MARY'S VILLA NURSING HOM
Provider Address
516 ST. MARY'S VILLA ROAD
MOSCOW, PA 18444
MOSCOW, PA 18444
Provider Phone Number
5708427621
Provider SSA County
420
Provider County Name
Lackawanna
Ownership Type
Non profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
108
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. MARY'S VILLA NURSING HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1977-01-01
Continuing Care Retirement Community
Y
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
2
Health Inspection Rating Footnote
QM Rating
5
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
2.64676
Reported LPN Staffing Hours per Resident per Day
0.87176
Reported RN Staffing Hours per Resident per Day
0.91574
Reported Licensed Staffing Hours per Resident per Day
1.78750
Reported Total Nurse Staffing Hours per Resident per Day
4.43426
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08333
Expected CNA Staffing Hours per Resident per Day
2.71502
Expected LPN Staffing Hours per Resident per Day
0.68771
Expected RN Staffing Hours per Resident per Day
1.12058
Expected Total Nurse Staffing Hours per Resident per Day
4.52332
Adjusted CNA Staffing Hours per Resident per Day
2.39201
Adjusted LPN Staffing Hours per Resident per Day
1.05212
Adjusted RN Staffing Hours per Resident per Day
0.61061
Adjusted Total Nurse Staffing Hours per Resident per Day
3.95154
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
2014-11-21
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
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
2013-12-19
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
50.66700
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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