Belmont Manor Nursing Home, In - Belmont Nursing Home
General Information
UPDATEFederal Provider Number
225419
Provider Name
BELMONT MANOR NURSING HOME, IN
Provider Address
34 AGASSIZ AVENUE
BELMONT, MA 2478
BELMONT, MA 2478
Provider Phone Number
(617) 489-1200
Provider SSA County
90
Provider County Name
Middlesex
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
135
Number of Residents in Certified Beds
127
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1990-07-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.95669
Reported LPN Staffing Hours per Resident per Day
0.62205
Reported RN Staffing Hours per Resident per Day
0.50512
Reported Licensed Staffing Hours per Resident per Day
1.12717
Reported Total Nurse Staffing Hours per Resident per Day
4.08386
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05630
Expected CNA Staffing Hours per Resident per Day
2.46490
Expected LPN Staffing Hours per Resident per Day
0.56553
Expected RN Staffing Hours per Resident per Day
0.79941
Expected Total Nurse Staffing Hours per Resident per Day
3.82984
Adjusted CNA Staffing Hours per Resident per Day
2.94326
Adjusted LPN Staffing Hours per Resident per Day
0.91294
Adjusted RN Staffing Hours per Resident per Day
0.47213
Adjusted Total Nurse Staffing Hours per Resident per Day
4.29826
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-03-16
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2014-01-23
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
1.33300
Number of Facility Reported Incidents
1
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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