Clover Rest Home - Columbia Nursing Home
General Information
UPDATEFederal Provider Number
315429
Provider Name
CLOVER REST HOME
Provider Address
28 WASHINGTON STREET
COLUMBIA, NJ 7832
COLUMBIA, NJ 7832
Provider Phone Number
9084964307
Provider SSA County
390
Provider County Name
Warren
Ownership Type
For profit - Partnership
Number of Certified Beds
33
Number of Residents in Certified Beds
33
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TAG SENIOR CARE LLC
Date First Approved to Provide Medicare and Medicaid services
1997-08-29
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.36818
Reported LPN Staffing Hours per Resident per Day
0.23333
Reported RN Staffing Hours per Resident per Day
0.93485
Reported Licensed Staffing Hours per Resident per Day
1.16818
Reported Total Nurse Staffing Hours per Resident per Day
3.53636
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04394
Expected CNA Staffing Hours per Resident per Day
2.46016
Expected LPN Staffing Hours per Resident per Day
0.52385
Expected RN Staffing Hours per Resident per Day
0.71151
Expected Total Nurse Staffing Hours per Resident per Day
3.69552
Adjusted CNA Staffing Hours per Resident per Day
2.36197
Adjusted LPN Staffing Hours per Resident per Day
0.36969
Adjusted RN Staffing Hours per Resident per Day
0.98174
Adjusted Total Nurse Staffing Hours per Resident per Day
3.85729
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
9.33300
Number of Facility Reported Incidents
0
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
Nursiong Homes Nearby
Forest Manor Hcc
145 State Park Road |
HOPE NJ 7844 | 8.8 miles away
Warren Haven
350 Oxford Road |
OXFORD NJ 7863 | 10 miles away
House Of The Good Shepherd
798 Willow Grove Street |
HACKETTSTOWN NJ 7840 | 15.4 miles away
Lopatcong Center
390 Red School Lane |
PHILLIPSBURG NJ 8865 | 15.5 miles away
Brakeley Park Center
290 Red School Lane |
PHILLIPSBURG NJ 8865 | 15.8 miles away
Heath Village
430 Schooley's Mountain Rd |
HACKETTSTOWN NJ 7840 | 16 miles away
Phillipsburg Center
843 Wilbur Avenue |
PHILLIPSBURG NJ 8865 | 17.3 miles away
Reviews: Be the first to review this provider.
Share your experience with Clover Rest Home. You can help others by writing a review.
