Siemons' Lakeview Manor Nursing And Rehab Ctr - Somerset Nursing Home
General Information
UPDATEFederal Provider Number
395398
Provider Name
SIEMONS' LAKEVIEW MANOR NURSING AND REHAB CTR
Provider Address
228 SIEMON DRIVE
SOMERSET, PA 15501
SOMERSET, PA 15501
Provider Phone Number
(814) 443-2811
Provider SSA County
680
Provider County Name
Somerset
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
113
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ENVOY OF SOMERSET, LLC
Date First Approved to Provide Medicare and Medicaid services
1978-07-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
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
1.71637
Reported LPN Staffing Hours per Resident per Day
0.80796
Reported RN Staffing Hours per Resident per Day
0.53584
Reported Licensed Staffing Hours per Resident per Day
1.34381
Reported Total Nurse Staffing Hours per Resident per Day
3.06017
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05442
Expected CNA Staffing Hours per Resident per Day
2.34513
Expected LPN Staffing Hours per Resident per Day
0.66952
Expected RN Staffing Hours per Resident per Day
1.25072
Expected Total Nurse Staffing Hours per Resident per Day
4.26537
Adjusted CNA Staffing Hours per Resident per Day
1.79583
Adjusted LPN Staffing Hours per Resident per Day
1.00162
Adjusted RN Staffing Hours per Resident per Day
0.32012
Adjusted Total Nurse Staffing Hours per Resident per Day
2.89195
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-10-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
54.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
12
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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