Queen of Peace Residence
110 30 221st St, Queens Village, NY 11429


Queen of Peace Residence is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 335606. The address is 110 30 221st St, Queens Village, NY 11429. The zip code is 11429. The phone number is 7184641800.


Queen of Peace Residence · 110 30 221st St, Queens Village, NY 11429

Federal Provider Number 335606
Provider Name QUEEN OF PEACE RESIDENCE
Address 110 30 221ST ST
QUEENS VILLAGE, NY 11429
Phone Number 7184641800
SSA County Code 590
County Name Queens
Ownership Type Non profit - Corporation
Certified Beds 53
Certified Beds Residents 52
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR
Date First Approved to Provide Medicare Medicaid Services 01/01/1977
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 4
Quality Measure Rating 5
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 2.93462
Reported LPN Staffing Hours per Resident per Day 0.31154
Reported RN Staffing Hours per Resident per Day 1.00096
Reported Licensed Staffing Hours per Resident per Day 1.3125
Reported Total Nurse Staffing Hours per Resident per Day 4.24712
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05481
Expected CNA Staffing Hours per Resident per Day 2.30863
Expected LPN Staffing Hours per Resident per Day 0.64236
Expected RN Staffing Hours per Resident per Day 0.92231
Expected Total Nurse Staffing Hours per Resident per Day 3.8733
Adjusted CNA Staffing Hours per Resident per Day 3.11903
Adjusted LPN Staffing Hours per Resident per Day 0.40255
Adjusted RN Staffing Hours per Resident per Day 0.81091
Adjusted Total Nurse Staffing Hours per Resident per Day 4.41993
Cycle 1 Standard Survey Health Date 10/28/2016
Cycle 2 Total Number of Health Deficiencies 1
Cycle 2 Number of Standard Health Deficiencies 1
Cycle 2 Health Deficiency Score 16
Cycle 2 Standard Health Survey Date 11/20/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 16
Cycle 3 Standard Health Survey Date 11/25/2014
Total Weighted Health Survey Score 5.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Queen of Peace Residence

Owner Name Role Association Date
ANDRADES, SANDRA (Individual) DIRECTOR since 05/01/2010
ANDRADES, SANDRA (Individual) OFFICER since 05/01/2010
FERRUCCI, CAROL ANN (Individual) DIRECTOR since 01/01/2015
FERRUCCI, CAROL ANN (Individual) OFFICER since 01/01/2015
MCLOUGHLIN, SHEILA (Individual) DIRECTOR since 08/14/2007
MCLOUGHLIN, SHEILA (Individual) OFFICER since 08/14/2007
VADUKKOOT, CELINE (Individual) DIRECTOR since 05/17/2011
VADUKKOOT, CELINE (Individual) OFFICER since 05/17/2011
VADUKKOOT, CELINE (Individual) OPERATIONAL/MANAGERIAL CONTROL since 05/01/2011

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