Park Avenue Extended Care Facility
425 National Boulevard, Long Beach, NY 11561


Park Avenue Extended Care Facility is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 335819. The address is 425 National Boulevard, Long Beach, NY 11561. The zip code is 11561. The phone number is 5164312600.


Park Avenue Extended Care Facility · 425 National Boulevard, Long Beach, NY 11561

Federal Provider Number 335819
Provider Name PARK AVENUE EXTENDED CARE FACILITY
Address 425 NATIONAL BOULEVARD
LONG BEACH, NY 11561
Phone Number 5164312600
SSA County Code 400
County Name Nassau
Ownership Type For profit - Corporation
Certified Beds 240
Certified Beds Residents 222
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name PARK AVENUE OPERATING COMPANY LLC
Date First Approved to Provide Medicare Medicaid Services 10/14/1999
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 4
Health Inspection Rating 4
Quality Measure Rating 5
Staffing Rating 1
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 2.21284
Reported LPN Staffing Hours per Resident per Day 0.8045
Reported RN Staffing Hours per Resident per Day 0.31216
Reported Licensed Staffing Hours per Resident per Day 1.11667
Reported Total Nurse Staffing Hours per Resident per Day 3.3295
Reported Physical Therapist Staffing Hours per Resident Per Day 0.08356
Expected CNA Staffing Hours per Resident per Day 2.57232
Expected LPN Staffing Hours per Resident per Day 0.75583
Expected RN Staffing Hours per Resident per Day 1.37341
Expected Total Nurse Staffing Hours per Resident per Day 4.70155
Adjusted CNA Staffing Hours per Resident per Day 2.1108
Adjusted LPN Staffing Hours per Resident per Day 0.88345
Adjusted RN Staffing Hours per Resident per Day 0.16983
Adjusted Total Nurse Staffing Hours per Resident per Day 2.85456
Cycle 1 Standard Survey Health Date 06/10/2016
Cycle 2 Total Number of Health Deficiencies 5
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Health Deficiency Score 20
Cycle 2 Standard Health Survey Date 06/23/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 20
Cycle 3 Total Number of Health Deficiencies 1
Cycle 3 Number of Standard Health Deficiencies 1
Cycle 3 Health Deficiency Score 4
Cycle 3 Standard Health Survey Date 06/12/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 4
Total Weighted Health Survey Score 7.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Park Avenue Extended Care Facility

Owner Name Role Association Date
BACCHI, ANTHONY (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
10%
since 07/23/2009
FARBENBLUM, MARTIN (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
10%
since 07/23/2009
FISCHL, MAYER (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
7%
since 07/23/2006
HOFFMAN, PINCHUS (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
7%
since 07/23/2009
LANDA, ESTHER (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
7%
since 07/23/2009
PHILIPSON, BENT (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
23%
since 07/23/2009
POCCHIA, TERESA (Individual) MANAGING EMPLOYEE since 08/16/2004

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