Davis Place - Danielson Nursing Home
General Information
UPDATEFederal Provider Number
75423
Provider Name
DAVIS PLACE
Provider Address
111 WESTCOTT RD
DANIELSON, CT 6239
DANIELSON, CT 6239
Provider Phone Number
(860) 774-9540
Provider SSA County
70
Provider County Name
Windham
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
190
Number of Residents in Certified Beds
171
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JACC HEALTHCARE CENTER OF DANIELSON LLC
Date First Approved to Provide Medicare and Medicaid services
2000-03-03
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.48187
Reported LPN Staffing Hours per Resident per Day
0.83158
Reported RN Staffing Hours per Resident per Day
0.74006
Reported Licensed Staffing Hours per Resident per Day
1.57164
Reported Total Nurse Staffing Hours per Resident per Day
4.05351
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13363
Expected CNA Staffing Hours per Resident per Day
2.26597
Expected LPN Staffing Hours per Resident per Day
0.60412
Expected RN Staffing Hours per Resident per Day
0.94178
Expected Total Nurse Staffing Hours per Resident per Day
3.81187
Adjusted CNA Staffing Hours per Resident per Day
2.68749
Adjusted LPN Staffing Hours per Resident per Day
1.14251
Adjusted RN Staffing Hours per Resident per Day
0.58715
Adjusted Total Nurse Staffing Hours per Resident per Day
4.28642
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-06-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-05-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
9
Number of Substantiated Complaints
3
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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