Apple Rehab Shelton Lakes - Shelton Nursing Home
General Information
UPDATEFederal Provider Number
75300
Provider Name
APPLE REHAB SHELTON LAKES
Provider Address
5 LAKE ROAD
SHELTON, CT 6484
SHELTON, CT 6484
Provider Phone Number
2039242635
Provider SSA County
0
Provider County Name
Fairfield
Ownership Type
For profit - Corporation
Number of Certified Beds
106
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHELTON LAKES HEALTH CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1982-11-17
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
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
2.55440
Reported LPN Staffing Hours per Resident per Day
0.94835
Reported RN Staffing Hours per Resident per Day
0.54890
Reported Licensed Staffing Hours per Resident per Day
1.49725
Reported Total Nurse Staffing Hours per Resident per Day
4.05165
Reported Physical Therapist Staffing Hours per Resident Per Day
0.19066
Expected CNA Staffing Hours per Resident per Day
2.39982
Expected LPN Staffing Hours per Resident per Day
0.61265
Expected RN Staffing Hours per Resident per Day
1.02357
Expected Total Nurse Staffing Hours per Resident per Day
4.03603
Adjusted CNA Staffing Hours per Resident per Day
2.61176
Adjusted LPN Staffing Hours per Resident per Day
1.28480
Adjusted RN Staffing Hours per Resident per Day
0.40069
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04650
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
22
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
180
Cycle 1 Standard Survey Health Date
2014-06-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
180
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-08-08
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
24
Cycle 3 Number of Standard Health Deficiencies
24
Cycle 3 Number of Complaint Health Deficiencies
13
Cycle 3 Health Deficiency Score
136
Cycle 3 Standard Health Survey Date
2012-07-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
136
Total Weighted Health Survey Score
150.00000
Number of Facility Reported Incidents
13
Number of Substantiated Complaints
5
Number of Fines
2
Total Amount of Fines in Dollars
12155
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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