Sullivan County Adult Care Center - Liberty Nursing Home
General Information
UPDATEFederal Provider Number
335628
Provider Name
SULLIVAN COUNTY ADULT CARE CENTER
Provider Address
256 SUNSET LAKE ROAD
LIBERTY, NY 12754
LIBERTY, NY 12754
Provider Phone Number
8452928640
Provider SSA County
710
Provider County Name
Sullivan
Ownership Type
Government - County
Number of Certified Beds
160
Number of Residents in Certified Beds
128
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF SULLIVAN
Date First Approved to Provide Medicare and Medicaid services
1978-04-11
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
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
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
2.37227
Reported LPN Staffing Hours per Resident per Day
0.66641
Reported RN Staffing Hours per Resident per Day
0.84102
Reported Licensed Staffing Hours per Resident per Day
1.50742
Reported Total Nurse Staffing Hours per Resident per Day
3.87970
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11719
Expected CNA Staffing Hours per Resident per Day
2.18440
Expected LPN Staffing Hours per Resident per Day
0.62767
Expected RN Staffing Hours per Resident per Day
1.04820
Expected Total Nurse Staffing Hours per Resident per Day
3.86027
Adjusted CNA Staffing Hours per Resident per Day
2.66473
Adjusted LPN Staffing Hours per Resident per Day
0.88122
Adjusted RN Staffing Hours per Resident per Day
0.59952
Adjusted Total Nurse Staffing Hours per Resident per Day
4.05119
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-12-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-03-27
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
366
Cycle 3 Standard Health Survey Date
2013-05-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
366
Total Weighted Health Survey Score
67.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
5200
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Achieve Rehab And Nursing Facility
170 Lake Street |
LIBERTY NY 12754 | 2.3 miles away
Catskill Regional Medical Center S N F
68 Bushville Road |
HARRIS NY 12742 | 6.3 miles away
Roscoe Regional Rehab & Residential H C F
420 Rockland Road |
ROSCOE NY 12776 | 15.2 miles away
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