St Josephs Place - Port Jervis Nursing Home
General Information
UPDATEFederal Provider Number
335692
Provider Name
ST JOSEPHS PLACE
Provider Address
160 EAST MAIN STREET
PORT JERVIS, NY 12771
PORT JERVIS, NY 12771
Provider Phone Number
(845) 856-5351
Provider SSA County
540
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
46
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
BON SECOURS COMMUNITY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1988-04-11
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
Partial
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.00897
Reported LPN Staffing Hours per Resident per Day
1.00128
Reported RN Staffing Hours per Resident per Day
1.03974
Reported Licensed Staffing Hours per Resident per Day
2.04103
Reported Total Nurse Staffing Hours per Resident per Day
4.04999
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12949
Expected CNA Staffing Hours per Resident per Day
2.60633
Expected LPN Staffing Hours per Resident per Day
0.76160
Expected RN Staffing Hours per Resident per Day
1.18957
Expected Total Nurse Staffing Hours per Resident per Day
4.55750
Adjusted CNA Staffing Hours per Resident per Day
1.89132
Adjusted LPN Staffing Hours per Resident per Day
1.09120
Adjusted RN Staffing Hours per Resident per Day
0.65309
Adjusted Total Nurse Staffing Hours per Resident per Day
3.58203
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
2014-04-30
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-04-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-04-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
8.66700
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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