Holly Manor Center - Mendham Nursing Home
General Information
UPDATEFederal Provider Number
315143
Provider Name
HOLLY MANOR CENTER
Provider Address
84 COLD HILL ROAD
MENDHAM, NJ 7945
MENDHAM, NJ 7945
Provider Phone Number
9735432500
Provider SSA County
300
Provider County Name
Morris
Ownership Type
For profit - Corporation
Number of Certified Beds
124
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
84 COLD HILL ROAD OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1973-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.19435
Reported LPN Staffing Hours per Resident per Day
0.30826
Reported RN Staffing Hours per Resident per Day
1.11826
Reported Licensed Staffing Hours per Resident per Day
1.42652
Reported Total Nurse Staffing Hours per Resident per Day
3.62087
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08870
Expected CNA Staffing Hours per Resident per Day
2.54037
Expected LPN Staffing Hours per Resident per Day
0.64834
Expected RN Staffing Hours per Resident per Day
1.02597
Expected Total Nurse Staffing Hours per Resident per Day
4.21468
Adjusted CNA Staffing Hours per Resident per Day
2.11949
Adjusted LPN Staffing Hours per Resident per Day
0.39463
Adjusted RN Staffing Hours per Resident per Day
0.81441
Adjusted Total Nurse Staffing Hours per Resident per Day
3.46298
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
2014-08-28
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-08-07
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-07-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
14.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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Pine Acres Convalescent Center
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