Kimberly Hall North - Windsor Nursing Home
General Information
UPDATEFederal Provider Number
75279
Provider Name
KIMBERLY HALL NORTH
Provider Address
1 EMERSON DR
WINDSOR, CT 6095
WINDSOR, CT 6095
Provider Phone Number
(860) 688-6443
Provider SSA County
10
Provider County Name
Hartford
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
150
Number of Residents in Certified Beds
135
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
1 EMERSON DRIVE NORTH OPERATIONS
Date First Approved to Provide Medicare and Medicaid services
1977-01-11
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
3
QM Rating Footnote
Staffing Rating
3
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
2.36148
Reported LPN Staffing Hours per Resident per Day
0.47222
Reported RN Staffing Hours per Resident per Day
0.73963
Reported Licensed Staffing Hours per Resident per Day
1.21185
Reported Total Nurse Staffing Hours per Resident per Day
3.57333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07926
Expected CNA Staffing Hours per Resident per Day
2.43730
Expected LPN Staffing Hours per Resident per Day
0.61698
Expected RN Staffing Hours per Resident per Day
0.92608
Expected Total Nurse Staffing Hours per Resident per Day
3.98036
Adjusted CNA Staffing Hours per Resident per Day
2.37737
Adjusted LPN Staffing Hours per Resident per Day
0.63526
Adjusted RN Staffing Hours per Resident per Day
0.59676
Adjusted Total Nurse Staffing Hours per Resident per Day
3.61870
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-04-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-05-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-04-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
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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