Sibley Mem Hosp Renaissance - Washington Nursing Home

General Information

UPDATE
Federal Provider Number
95030
Provider Name
SIBLEY MEM HOSP RENAISSANCE
Provider Address
5255 LOUGHBORO ROAD NW
WASHINGTON, DC 20016
Provider Phone Number
2025374000
Provider SSA County
0
Provider County Name
The District
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
24
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIE
Date First Approved to Provide Medicare and Medicaid services
1994-05-27
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
3
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
3.79792
Reported LPN Staffing Hours per Resident per Day
0.72708
Reported RN Staffing Hours per Resident per Day
5.70000
Reported Licensed Staffing Hours per Resident per Day
6.42708
Reported Total Nurse Staffing Hours per Resident per Day
10.22500
Reported Physical Therapist Staffing Hours per Resident Per Day
1.52292
Expected CNA Staffing Hours per Resident per Day
2.24987
Expected LPN Staffing Hours per Resident per Day
0.71372
Expected RN Staffing Hours per Resident per Day
1.69248
Expected Total Nurse Staffing Hours per Resident per Day
4.65607
Adjusted CNA Staffing Hours per Resident per Day
4.14199
Adjusted LPN Staffing Hours per Resident per Day
0.84553
Adjusted RN Staffing Hours per Resident per Day
2.51646
Adjusted Total Nurse Staffing Hours per Resident per Day
8.85209
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
72
Cycle 1 Standard Survey Health Date
2014-09-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-08-23
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
2012-07-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
52.00000
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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