Shady Grove Center - Rockville Nursing Home
General Information
UPDATEFederal Provider Number
215164
Provider Name
SHADY GROVE CENTER
Provider Address
9701 MEDICAL CENTER DRIVE
ROCKVILLE, MD 20850
ROCKVILLE, MD 20850
Provider Phone Number
3013151900
Provider SSA County
150
Provider County Name
Montgomery
Ownership Type
For profit - Corporation
Number of Certified Beds
134
Number of Residents in Certified Beds
130
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
9701 MEDICAL CENTER DRIVE OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1987-06-05
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
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
1.95577
Reported LPN Staffing Hours per Resident per Day
1.09000
Reported RN Staffing Hours per Resident per Day
0.70538
Reported Licensed Staffing Hours per Resident per Day
1.79538
Reported Total Nurse Staffing Hours per Resident per Day
3.75115
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11654
Expected CNA Staffing Hours per Resident per Day
2.47742
Expected LPN Staffing Hours per Resident per Day
0.67930
Expected RN Staffing Hours per Resident per Day
1.19872
Expected Total Nurse Staffing Hours per Resident per Day
4.35545
Adjusted CNA Staffing Hours per Resident per Day
1.93704
Adjusted LPN Staffing Hours per Resident per Day
1.33181
Adjusted RN Staffing Hours per Resident per Day
0.43969
Adjusted Total Nurse Staffing Hours per Resident per Day
3.47163
Cycle 1 Total Number of Health Deficiencies
20
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
23
Cycle 2 Number of Standard Health Deficiencies
18
Cycle 2 Number of Complaint Health Deficiencies
23
Cycle 2 Health Deficiency Score
120
Cycle 2 Standard Health Survey Date
2013-04-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-06-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
98.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
10
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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