Provider Name: CHENANGO MEMORIAL HOSPITAL INC S N F
Address: 179 NORTH BROAD STREET, NORWICH, NY 13815
Phone: (607) 337-4111
County: Chenango (080)
Ownership Type: Non profit - Corporation
Certified Beds: 80
Average Residents Per Day: 25.1 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: CHENANGO MEMORIAL HOSPITAL INC
First Approved Date: February 21, 1972
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 4 ()
QM Rating: 4 ()
Long Stay QM Rating: 4 ()
Short Stay QM Rating: (2)
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.85770, LPN Staff Hours Per Day: 1.5102, RN Staff Hours Per Day: 0.6398, Licensed Staff Hours Per Day: 2.1501
Total Nurse Staff Hours Per Day, per resident: 5.00783
Weekend Nurse Staff Hours: 4.37500, Weekend RN Staff Hours: 0.4023
PT Staff Hours Per Day, per resident: 0.0393
Nurse Staff Turnover: 32.3, Nurse Turnover Note:
RN Turnover: , RN Turnover Note: 6
Admin Left Number: 1, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.1147, Case Mix LPN Hours Per Day: 0.6528, Case Mix RN Hours Per Day: 0.2879
Adjusted Nurse Aide Hours Per Day, per resident: 2.75300, Adjusted LPN Hours Per Day: 1.7071, Adjusted RN Hours Per Day: 0.8374
Total Adjusted Nurse Hours Per Day, per resident: 5.16606
Adjusted Weekend Nurse Hours Per Day, per resident: 4.51324
Health Survey Dates and Scores: Cycle 1: 2022-01-07 (Score: 0), Cycle 2: 2019-08-13 (Score: 16), Cycle 3: 2018-04-20 (Score: 12)
Total Weighted Health Score: 7.333
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 2, Total Fines in Dollars: 1630.08, Payment Denials Number: 0, Total Penalties Number: 2
Location and GPS: 179 NORTH BROAD STREET,NORWICH,NY,13815 (42.5406, -75.525)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Ensure residents have reasonable access to and privacy in their use of communication methods.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-09-12
Type: Health, Deficiency: Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-09-12
Type: Health, Deficiency: Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-09-12
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-19
Type: Health, Deficiency: Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-19
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0311, Version: New
Description: Have an enclosure around a vertical opening shaft.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-02-23
Type: Fire Safety, Tag: 0321, Version: New
Description: Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-02-23
Type: Fire Safety, Tag: 0909, Version: New
Description: Ensure gas and vacuum piping is labeled.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-02-23
Type: Fire Safety, Tag: 0909, Version: New
Description: Ensure gas and vacuum piping is labeled.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-08-16
Type: Fire Safety, Tag: 0921, Version: New
Description: Ensure that testing and maintenance of electrical equipment is performed.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-08-28
Type: Fire Safety, Tag: 0345, Version: New
Description: Have approved installation, maintenance and testing program for fire alarm systems.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-05-10
Type: Fire Safety, Tag: 0351, Version: New
Description: Install an approved automatic sprinkler system.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-11
Type: Fire Safety, Tag: 0531, Version: New
Description: Have elevators that firefighters can control in the event of a fire.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-11
Type: Fire Safety, Tag: 0920, Version: New
Description: Ensure proper usage of power strips and extension cords.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-11