Autumn Lake Healthcare At Bucks Hill - Waterbury Nursing Home
General Information
UPDATEFederal Provider Number
75418
Provider Name
AUTUMN LAKE HEALTHCARE AT BUCKS HILL
Provider Address
2817 NORTH MAIN STREET
WATERBURY, CT 6704
WATERBURY, CT 6704
Provider Phone Number
(203) 757-0731
Provider SSA County
40
Provider County Name
New Haven
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BUCKS HILL OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1999-02-04
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.05291
Reported LPN Staffing Hours per Resident per Day
0.63779
Reported RN Staffing Hours per Resident per Day
0.69128
Reported Licensed Staffing Hours per Resident per Day
1.32907
Reported Total Nurse Staffing Hours per Resident per Day
3.38198
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15523
Expected CNA Staffing Hours per Resident per Day
2.61227
Expected LPN Staffing Hours per Resident per Day
0.60072
Expected RN Staffing Hours per Resident per Day
0.94064
Expected Total Nurse Staffing Hours per Resident per Day
4.15362
Adjusted CNA Staffing Hours per Resident per Day
1.92830
Adjusted LPN Staffing Hours per Resident per Day
0.88122
Adjusted RN Staffing Hours per Resident per Day
0.54912
Adjusted Total Nurse Staffing Hours per Resident per Day
3.28206
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-11-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-12-13
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-10-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
5
Number of Fines
1
Total Amount of Fines in Dollars
1300
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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