Ten Broeck Commons - Lake Katrine Nursing Home
General Information
UPDATEFederal Provider Number
335765
Provider Name
TEN BROECK COMMONS
Provider Address
ONE COMMONS DRIVE
LAKE KATRINE, NY 12449
LAKE KATRINE, NY 12449
Provider Phone Number
(845) 336-6666
Provider SSA County
740
Provider County Name
Ulster
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
258
Number of Residents in Certified Beds
254
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TENBC INC
Date First Approved to Provide Medicare and Medicaid services
1993-03-26
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
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
2.44902
Reported LPN Staffing Hours per Resident per Day
0.83150
Reported RN Staffing Hours per Resident per Day
0.47874
Reported Licensed Staffing Hours per Resident per Day
1.31024
Reported Total Nurse Staffing Hours per Resident per Day
3.75926
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05886
Expected CNA Staffing Hours per Resident per Day
2.61522
Expected LPN Staffing Hours per Resident per Day
0.69561
Expected RN Staffing Hours per Resident per Day
1.10044
Expected Total Nurse Staffing Hours per Resident per Day
4.41127
Adjusted CNA Staffing Hours per Resident per Day
2.29777
Adjusted LPN Staffing Hours per Resident per Day
0.99215
Adjusted RN Staffing Hours per Resident per Day
0.32506
Adjusted Total Nurse Staffing Hours per Resident per Day
3.43511
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
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
8
Cycle 2 Standard Health Survey Date
2013-09-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-06-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
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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