Ingleside At King Farm - Rockville Nursing Home
General Information
UPDATEFederal Provider Number
215353
Provider Name
INGLESIDE AT KING FARM
Provider Address
701 KING FARM BOULEVARD
ROCKVILLE, MD 20850
ROCKVILLE, MD 20850
Provider Phone Number
2404999015
Provider SSA County
150
Provider County Name
Montgomery
Ownership Type
Non profit - Corporation
Number of Certified Beds
26
Number of Residents in Certified Beds
24
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KING FARM PRESBYTERIAN RETIREMENT COMMUNITY, INC.
Date First Approved to Provide Medicare and Medicaid services
2009-06-30
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
3.06667
Reported LPN Staffing Hours per Resident per Day
0.54167
Reported RN Staffing Hours per Resident per Day
1.16667
Reported Licensed Staffing Hours per Resident per Day
1.70833
Reported Total Nurse Staffing Hours per Resident per Day
4.77501
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06042
Expected CNA Staffing Hours per Resident per Day
2.53409
Expected LPN Staffing Hours per Resident per Day
0.61533
Expected RN Staffing Hours per Resident per Day
1.03881
Expected Total Nurse Staffing Hours per Resident per Day
4.18823
Adjusted CNA Staffing Hours per Resident per Day
2.96939
Adjusted LPN Staffing Hours per Resident per Day
0.73064
Adjusted RN Staffing Hours per Resident per Day
0.83917
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59564
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-05-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-05-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-06-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
9.33300
Number of Facility Reported Incidents
0
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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