Avalon Health Care Center At Stoneridge - Mystic Nursing Home
General Information
UPDATEFederal Provider Number
75437
Provider Name
AVALON HEALTH CARE CENTER AT STONERIDGE
Provider Address
186 JERRY BROWNE ROAD
MYSTIC, CT 6355
MYSTIC, CT 6355
Provider Phone Number
(860) 536-9700
Provider SSA County
50
Provider County Name
New London
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
40
Number of Residents in Certified Beds
36
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
LCS WESTMINSTER PARTNERSHIP I LLP
Date First Approved to Provide Medicare and Medicaid services
2004-11-24
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.18194
Reported LPN Staffing Hours per Resident per Day
0.82361
Reported RN Staffing Hours per Resident per Day
1.62639
Reported Licensed Staffing Hours per Resident per Day
2.45000
Reported Total Nurse Staffing Hours per Resident per Day
4.63194
Reported Physical Therapist Staffing Hours per Resident Per Day
0.42500
Expected CNA Staffing Hours per Resident per Day
2.34760
Expected LPN Staffing Hours per Resident per Day
0.59239
Expected RN Staffing Hours per Resident per Day
1.08741
Expected Total Nurse Staffing Hours per Resident per Day
4.02740
Adjusted CNA Staffing Hours per Resident per Day
2.28055
Adjusted LPN Staffing Hours per Resident per Day
1.15396
Adjusted RN Staffing Hours per Resident per Day
1.11756
Adjusted Total Nurse Staffing Hours per Resident per Day
4.63597
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-02-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-03-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
0
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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