Kimberly Hall-south Center - Windsor Nursing Home
General Information
UPDATEFederal Provider Number
75237
Provider Name
KIMBERLY HALL-SOUTH CENTER
Provider Address
1 EMERSON DRIVE
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
180
Number of Residents in Certified Beds
113
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
1 EMERSON DRIVE SOUTH OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1975-11-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.98938
Reported LPN Staffing Hours per Resident per Day
0.73363
Reported RN Staffing Hours per Resident per Day
0.75310
Reported Licensed Staffing Hours per Resident per Day
1.48673
Reported Total Nurse Staffing Hours per Resident per Day
3.47611
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17080
Expected CNA Staffing Hours per Resident per Day
2.36850
Expected LPN Staffing Hours per Resident per Day
0.65772
Expected RN Staffing Hours per Resident per Day
1.12150
Expected Total Nurse Staffing Hours per Resident per Day
4.14772
Adjusted CNA Staffing Hours per Resident per Day
2.06094
Adjusted LPN Staffing Hours per Resident per Day
0.92580
Adjusted RN Staffing Hours per Resident per Day
0.50175
Adjusted Total Nurse Staffing Hours per Resident per Day
3.37821
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-07-31
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
12
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-09-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
48.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
2
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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