Douglas Manor - Windham Nursing Home
General Information
UPDATEFederal Provider Number
75258
Provider Name
DOUGLAS MANOR
Provider Address
103 NORTH RD
WINDHAM, CT 6280
WINDHAM, CT 6280
Provider Phone Number
(860) 423-4636
Provider SSA County
70
Provider County Name
Windham
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
81
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEALTH CARE ASSURANCE, LLC D/B/A DOUGLAS MANOR
Date First Approved to Provide Medicare and Medicaid services
1976-04-08
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
2.76975
Reported LPN Staffing Hours per Resident per Day
1.14815
Reported RN Staffing Hours per Resident per Day
0.85432
Reported Licensed Staffing Hours per Resident per Day
2.00247
Reported Total Nurse Staffing Hours per Resident per Day
4.77222
Reported Physical Therapist Staffing Hours per Resident Per Day
0.21173
Expected CNA Staffing Hours per Resident per Day
2.40342
Expected LPN Staffing Hours per Resident per Day
0.60288
Expected RN Staffing Hours per Resident per Day
1.01614
Expected Total Nurse Staffing Hours per Resident per Day
4.02244
Adjusted CNA Staffing Hours per Resident per Day
2.82769
Adjusted LPN Staffing Hours per Resident per Day
1.58069
Adjusted RN Staffing Hours per Resident per Day
0.62821
Adjusted Total Nurse Staffing Hours per Resident per Day
4.78226
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-11-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
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
2013-10-24
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-09-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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