Elim Park Baptist Home, Inc - Cheshire Nursing Home
General Information
UPDATEFederal Provider Number
75265
Provider Name
ELIM PARK BAPTIST HOME, INC
Provider Address
140 COOK HILL RD
CHESHIRE, CT 6410
CHESHIRE, CT 6410
Provider Phone Number
(203) 272-3547
Provider SSA County
40
Provider County Name
New Haven
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
85
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ELIM PARK BAPTIST HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1976-03-20
Continuing Care Retirement Community
Y
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
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
2.74471
Reported LPN Staffing Hours per Resident per Day
0.75824
Reported RN Staffing Hours per Resident per Day
1.36235
Reported Licensed Staffing Hours per Resident per Day
2.12059
Reported Total Nurse Staffing Hours per Resident per Day
4.86530
Reported Physical Therapist Staffing Hours per Resident Per Day
0.29294
Expected CNA Staffing Hours per Resident per Day
2.70515
Expected LPN Staffing Hours per Resident per Day
0.64492
Expected RN Staffing Hours per Resident per Day
1.00489
Expected Total Nurse Staffing Hours per Resident per Day
4.35496
Adjusted CNA Staffing Hours per Resident per Day
2.48958
Adjusted LPN Staffing Hours per Resident per Day
0.97585
Adjusted RN Staffing Hours per Resident per Day
1.01300
Adjusted Total Nurse Staffing Hours per Resident per Day
4.50327
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-09-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-08-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
1495
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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