Wilkinson Residential Health Care Facility - Amsterdam Nursing Home
General Information
UPDATEFederal Provider Number
335857
Provider Name
WILKINSON RESIDENTIAL HEALTH CARE FACILITY
Provider Address
4988 STATE HWY 30
AMSTERDAM, NY 12010
AMSTERDAM, NY 12010
Provider Phone Number
(518) 841-3572
Provider SSA County
380
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
160
Number of Residents in Certified Beds
160
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
ST. MARY'S HEALTHCARE
Date First Approved to Provide Medicare and Medicaid services
2009-06-17
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.24656
Reported LPN Staffing Hours per Resident per Day
1.14063
Reported RN Staffing Hours per Resident per Day
0.62969
Reported Licensed Staffing Hours per Resident per Day
1.77031
Reported Total Nurse Staffing Hours per Resident per Day
4.01688
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05750
Expected CNA Staffing Hours per Resident per Day
2.54643
Expected LPN Staffing Hours per Resident per Day
0.58019
Expected RN Staffing Hours per Resident per Day
0.97308
Expected Total Nurse Staffing Hours per Resident per Day
4.09970
Adjusted CNA Staffing Hours per Resident per Day
2.16475
Adjusted LPN Staffing Hours per Resident per Day
1.63173
Adjusted RN Staffing Hours per Resident per Day
0.48352
Adjusted Total Nurse Staffing Hours per Resident per Day
3.94947
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-08
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
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-12-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2013-01-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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