Ingraham Manor - Bristol Nursing Home
General Information
UPDATEFederal Provider Number
75329
Provider Name
INGRAHAM MANOR
Provider Address
400 N MAIN ST
BRISTOL, CT 6010
BRISTOL, CT 6010
Provider Phone Number
(860) 584-3400
Provider SSA County
10
Provider County Name
Hartford
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
128
Number of Residents in Certified Beds
121
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BRISTOL HEALTH CARE, INC.
Date First Approved to Provide Medicare and Medicaid services
1989-12-29
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.52438
Reported LPN Staffing Hours per Resident per Day
0.58512
Reported RN Staffing Hours per Resident per Day
0.79463
Reported Licensed Staffing Hours per Resident per Day
1.37975
Reported Total Nurse Staffing Hours per Resident per Day
3.90413
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10165
Expected CNA Staffing Hours per Resident per Day
2.52734
Expected LPN Staffing Hours per Resident per Day
0.61385
Expected RN Staffing Hours per Resident per Day
0.96066
Expected Total Nurse Staffing Hours per Resident per Day
4.10185
Adjusted CNA Staffing Hours per Resident per Day
2.45082
Adjusted LPN Staffing Hours per Resident per Day
0.79115
Adjusted RN Staffing Hours per Resident per Day
0.61806
Adjusted Total Nurse Staffing Hours per Resident per Day
3.83660
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-04-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2013-02-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
116
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-02-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
84.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
1170
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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