Forest Haven Nursing Home - Catonsville Nursing Home
General Information
UPDATEFederal Provider Number
215252
Provider Name
FOREST HAVEN NURSING HOME
Provider Address
701 EDMONDSON AVENUE
CATONSVILLE, MD 21228
CATONSVILLE, MD 21228
Provider Phone Number
(410) 747-7425
Provider SSA County
20
Provider County Name
Baltimore
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
167
Number of Residents in Certified Beds
159
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOREST HAVEN NURSING AND REHABILITATION CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1993-08-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.61824
Reported LPN Staffing Hours per Resident per Day
0.77925
Reported RN Staffing Hours per Resident per Day
0.42893
Reported Licensed Staffing Hours per Resident per Day
1.20818
Reported Total Nurse Staffing Hours per Resident per Day
3.82642
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04088
Expected CNA Staffing Hours per Resident per Day
2.45748
Expected LPN Staffing Hours per Resident per Day
0.60520
Expected RN Staffing Hours per Resident per Day
1.03515
Expected Total Nurse Staffing Hours per Resident per Day
4.09783
Adjusted CNA Staffing Hours per Resident per Day
2.61421
Adjusted LPN Staffing Hours per Resident per Day
1.06870
Adjusted RN Staffing Hours per Resident per Day
0.30961
Adjusted Total Nurse Staffing Hours per Resident per Day
3.76392
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
64
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
64
Cycle 2 Total Number of Health Deficiencies
21
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
19
Cycle 2 Health Deficiency Score
156
Cycle 2 Standard Health Survey Date
2013-08-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
156
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
10
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-06-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
91.33300
Number of Facility Reported Incidents
16
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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