Carroll Manor Nursing & Rehab - Washington Nursing Home
General Information
UPDATEFederal Provider Number
95034
Provider Name
CARROLL MANOR NURSING & REHAB
Provider Address
725 BUCHANAN ST., NE
WASHINGTON, DC 20017
WASHINGTON, DC 20017
Provider Phone Number
(202) 269-7221
Provider SSA County
0
Provider County Name
The District
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
252
Number of Residents in Certified Beds
231
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
PROVIDENCE HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1996-03-20
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
3
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
2.73745
Reported LPN Staffing Hours per Resident per Day
1.34740
Reported RN Staffing Hours per Resident per Day
1.05433
Reported Licensed Staffing Hours per Resident per Day
2.40173
Reported Total Nurse Staffing Hours per Resident per Day
5.13918
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08615
Expected CNA Staffing Hours per Resident per Day
2.45953
Expected LPN Staffing Hours per Resident per Day
0.62134
Expected RN Staffing Hours per Resident per Day
0.87814
Expected Total Nurse Staffing Hours per Resident per Day
3.95902
Adjusted CNA Staffing Hours per Resident per Day
2.73096
Adjusted LPN Staffing Hours per Resident per Day
1.79989
Adjusted RN Staffing Hours per Resident per Day
0.89711
Adjusted Total Nurse Staffing Hours per Resident per Day
5.23249
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-09-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-09-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
23
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2012-09-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
120
Total Weighted Health Survey Score
74.66700
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
4
Number of Fines
2
Total Amount of Fines in Dollars
9550
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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