Chapel Manor
1104 Welsh Road, Philadelphia, PA 19115


Chapel Manor is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 395449. The address is 1104 Welsh Road, Philadelphia, PA 19115. The zip code is 19115. The phone number is 2156769191.


Chapel Manor · 1104 Welsh Road, Philadelphia, PA 19115

Federal Provider Number 395449
Provider Name CHAPEL MANOR
Address 1104 WELSH ROAD
PHILADELPHIA, PA 19115
Phone Number 2156769191
SSA County Code 620
County Name Philadelphia
Ownership Type For profit - Partnership
Certified Beds 238
Certified Beds Residents 221
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name 1104 WELSH ROAD OPERATIONS LLC
Date First Approved to Provide Medicare Medicaid Services 12/01/1979
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 3
Health Inspection Rating 3
Quality Measure Rating 2
Staffing Rating 2
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 1.97421
Reported LPN Staffing Hours per Resident per Day 0.6009
Reported RN Staffing Hours per Resident per Day 0.88258
Reported Licensed Staffing Hours per Resident per Day 1.48348
Reported Total Nurse Staffing Hours per Resident per Day 3.45769
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05362
Expected CNA Staffing Hours per Resident per Day 2.48566
Expected LPN Staffing Hours per Resident per Day 0.71299
Expected RN Staffing Hours per Resident per Day 1.17868
Expected Total Nurse Staffing Hours per Resident per Day 4.37733
Adjusted CNA Staffing Hours per Resident per Day 1.94883
Adjusted LPN Staffing Hours per Resident per Day 0.69952
Adjusted RN Staffing Hours per Resident per Day 0.55949
Adjusted Total Nurse Staffing Hours per Resident per Day 3.18404
Cycle 1 Total Number of Health Deficiencies 9
Cycle 1 Number of Standard Health Deficiencies 9
Cycle 1 Number of Complaint Health Deficiencies 1
Cycle 1 Health Deficiency Score 60
Cycle 1 Standard Survey Health Date 07/12/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Health Revisit Score 0
Cycle 1 Total Health Score 60
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 28
Cycle 2 Standard Health Survey Date 09/03/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Health Revisit Score 0
Cycle 2 Total Health Score 28
Cycle 3 Total Number of Health Deficiencies 2
Cycle 3 Number of Standard Health Deficiencies 2
Cycle 3 Number of Complaint Health Deficiencies 0
Cycle 3 Health Deficiency Score 12
Cycle 3 Standard Health Survey Date 07/01/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Health Revisit Score 0
Cycle 3 Total Health Score 12
Total Weighted Health Survey Score 41.333
Number of Facility Reported Incidents 2
Number of Substantiated Complaints 2
Number of Fines 0
Total Amount of Fines in Dollars $0.00
Number of Payment Denials 0
Total Number of Penalties 0
Processing Date 08/01/2017

Owner or Manager · Chapel Manor

Owner Name Role Association Date
AMBROSE, TARA (Individual) MANAGING EMPLOYEE since 01/01/2013
AMBROSE, TARA (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/01/2013
BECKWITH, BRIAN (Individual) DIRECTOR since 12/31/2011
BERG, MICHAEL (Individual) OFFICER since 12/01/2012
BERG, MICHAEL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
CENTAK, SCOTT (Individual) MANAGING EMPLOYEE since 04/01/2011
DAVIS, KEITH (Individual) MANAGING EMPLOYEE since 04/01/2011
DAVIS, KEITH (Individual) OFFICER since 04/01/2011
DAVIS, KEITH (Individual) OPERATIONAL/MANAGERIAL CONTROL since 04/01/2011
DIVITTORIO, THOMAS (Individual) DIRECTOR since 04/01/2011
DONNA REIS 1995 FAM TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
DVORAK, JOSEPH (Individual) MANAGING EMPLOYEE since 04/01/2011
DVORAK, JOSEPH (Individual) OFFICER since 04/01/2011
EDWARDS, JAN (Individual) DIRECTOR since 04/01/2011
EDWARDS, JAN (Individual) OFFICER since 04/01/2011
EVANS, CHRISTOPHER (Individual) OFFICER since 03/01/2017
FC-GEN OPERATIONS INVESTMENT LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
FIRTH, CHRISTINA (Individual) DIRECTOR since 04/01/2011
FIRTH, CHRISTINA (Individual) OFFICER since 04/01/2011
FISHMAN, STEVEN (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
FISHMAN, STEVEN (Individual) DIRECTOR since 12/31/2011
FISHMAN, STEVEN (Individual) OFFICER since 12/31/2011
GEN MANAGEMENT LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
GEN OPERATIONS I LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
GEN OPERATIONS II, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
GENERAL ELECTRIC CAPITAL CORPORATION (Organization) 5% OR GREATER SECURITY INTEREST since 12/31/2011
GENESIS HEALTHCARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
GENESIS HEALTHCARE LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 04/01/2011
GENESIS OPERATIONS IV LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
GENESIS PA HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
GHC HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
HAGER, GEORGE (Individual) DIRECTOR since 04/01/2011
HAGER, GEORGE (Individual) OFFICER since 11/01/2012
HAGER, GEORGE (Individual) OPERATIONAL/MANAGERIAL CONTROL since 04/01/2011
HARTMAN, ROBERT (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/01/2012
HARTMAN, ROBERT (Individual) DIRECTOR since 04/01/2011
HCCF MANAGEMENT GROUP XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
NEUBERGER, ISAAC (Individual) DIRECTOR since 04/01/2011
REIS, DAVID (Individual) DIRECTOR since 12/31/2011
REIS, DAVID (Individual) OFFICER since 04/01/2011
REITZ, ROBERT (Individual) DIRECTOR since 04/01/2011
REITZ, ROBERT (Individual) OFFICER since 11/01/2012
REITZ, ROBERT (Individual) OPERATIONAL/MANAGERIAL CONTROL since 04/01/2011
ROSENBLUM, ISRAEL (Individual) DIRECTOR since 12/01/2012
SENIOR CARE GENESIS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
SENIOR CARE HOLDINGS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
SHERMAN, MICHAEL (Individual) DIRECTOR since 04/01/2011
SHERMAN, MICHAEL (Individual) OFFICER since 04/01/2011
SHERMAN, MICHAEL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 04/01/2011
WHITMAN, ARNOLD (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
WHITMAN, ARNOLD (Individual) DIRECTOR since 04/01/2011
WHITMAN, ARNOLD (Individual) OFFICER since 04/01/2011
WIESS, MARK (Individual) OFFICER since 03/01/2017
ZAC PROPERTIES XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011

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