Cobalt Lodge Health Care & Reh - Cobalt Nursing Home
General Information
UPDATEFederal Provider Number
75232
Provider Name
COBALT LODGE HEALTH CARE & REH
Provider Address
29 MIDDLE HADDAM RD
COBALT, CT 6414
COBALT, CT 6414
Provider Phone Number
(860) 267-9034
Provider SSA County
30
Provider County Name
Middlesex
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Z INCORPORATED
Date First Approved to Provide Medicare and Medicaid services
1974-09-30
Continuing Care Retirement Community
N
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.14000
Reported LPN Staffing Hours per Resident per Day
0.51909
Reported RN Staffing Hours per Resident per Day
0.77818
Reported Licensed Staffing Hours per Resident per Day
1.29727
Reported Total Nurse Staffing Hours per Resident per Day
3.43727
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11727
Expected CNA Staffing Hours per Resident per Day
2.44636
Expected LPN Staffing Hours per Resident per Day
0.59670
Expected RN Staffing Hours per Resident per Day
0.91166
Expected Total Nurse Staffing Hours per Resident per Day
3.95472
Adjusted CNA Staffing Hours per Resident per Day
2.14642
Adjusted LPN Staffing Hours per Resident per Day
0.72204
Adjusted RN Staffing Hours per Resident per Day
0.63780
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50348
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
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
8
Cycle 2 Standard Health Survey Date
2013-12-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2013-01-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
48.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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