St Johns Penfield Homes Corporation - Fairport Nursing Home
General Information
UPDATEFederal Provider Number
335863
Provider Name
ST JOHNS PENFIELD HOMES CORPORATION
Provider Address
65 SONOMA DRIVE
FAIRPORT, NY 14450
FAIRPORT, NY 14450
Provider Phone Number
(585) 292-5250
Provider SSA County
370
Provider County Name
Monroe
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
20
Number of Residents in Certified Beds
18
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. JOHN'S PENFIELD HOMES CORPORATION
Date First Approved to Provide Medicare and Medicaid services
2012-02-28
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
3
Health Inspection Rating Footnote
QM Rating
3
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
3.11111
Reported LPN Staffing Hours per Resident per Day
1.31389
Reported RN Staffing Hours per Resident per Day
0.60278
Reported Licensed Staffing Hours per Resident per Day
1.91667
Reported Total Nurse Staffing Hours per Resident per Day
5.02778
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01111
Expected CNA Staffing Hours per Resident per Day
2.73762
Expected LPN Staffing Hours per Resident per Day
0.55545
Expected RN Staffing Hours per Resident per Day
0.74988
Expected Total Nurse Staffing Hours per Resident per Day
4.04295
Adjusted CNA Staffing Hours per Resident per Day
2.78846
Adjusted LPN Staffing Hours per Resident per Day
1.96331
Adjusted RN Staffing Hours per Resident per Day
0.60063
Adjusted Total Nurse Staffing Hours per Resident per Day
5.01280
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-12-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
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
0
Cycle 2 Standard Health Survey Date
2014-02-28
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-04-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
15.33300
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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