Ellis Manor - Hartford Nursing Home
General Information
UPDATEFederal Provider Number
75239
Provider Name
ELLIS MANOR
Provider Address
210 GEORGE ST
HARTFORD, CT 6114
HARTFORD, CT 6114
Provider Phone Number
(860) 296-9166
Provider SSA County
10
Provider County Name
Hartford
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
99
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEALTH CARE RELIANCE LLC D/B/A ELLIS MANOR
Date First Approved to Provide Medicare and Medicaid services
1975-06-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
2.05354
Reported LPN Staffing Hours per Resident per Day
0.66970
Reported RN Staffing Hours per Resident per Day
0.81162
Reported Licensed Staffing Hours per Resident per Day
1.48131
Reported Total Nurse Staffing Hours per Resident per Day
3.53486
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05758
Expected CNA Staffing Hours per Resident per Day
2.36884
Expected LPN Staffing Hours per Resident per Day
0.62172
Expected RN Staffing Hours per Resident per Day
1.02140
Expected Total Nurse Staffing Hours per Resident per Day
4.01196
Adjusted CNA Staffing Hours per Resident per Day
2.12711
Adjusted LPN Staffing Hours per Resident per Day
0.89406
Adjusted RN Staffing Hours per Resident per Day
0.59374
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55155
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2012-04-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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