Hackensack-umc Mountainside - Montclair Nursing Home
General Information
UPDATEFederal Provider Number
315389
Provider Name
HACKENSACK-UMC MOUNTAINSIDE
Provider Address
ONE BAY AVE
MONTCLAIR, NJ 7042
MONTCLAIR, NJ 7042
Provider Phone Number
(973) 429-6949
Provider SSA County
200
Provider County Name
Essex
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
18
Number of Residents in Certified Beds
13
Provider Type
Medicare
Provider Resides in Hospital
Y
Legal Business Name
MONTCLAIR HOSPITAL LLC
Date First Approved to Provide Medicare and Medicaid services
1998-01-08
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
1.73077
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
4.43462
Reported Licensed Staffing Hours per Resident per Day
4.43462
Reported Total Nurse Staffing Hours per Resident per Day
6.16539
Reported Physical Therapist Staffing Hours per Resident Per Day
1.33077
Expected CNA Staffing Hours per Resident per Day
2.14751
Expected LPN Staffing Hours per Resident per Day
0.78445
Expected RN Staffing Hours per Resident per Day
1.76687
Expected Total Nurse Staffing Hours per Resident per Day
4.69883
Adjusted CNA Staffing Hours per Resident per Day
1.97754
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
1.87537
Adjusted Total Nurse Staffing Hours per Resident per Day
5.28899
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
8
Cycle 1 Standard Survey Health Date
2014-09-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-12-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-12-27
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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