Manorcare Health Services - Potomac - Potomac Nursing Home
General Information
UPDATEFederal Provider Number
215171
Provider Name
MANORCARE HEALTH SERVICES - POTOMAC
Provider Address
10714 POTOMAC TENNIS LANE
POTOMAC, MD 20854
POTOMAC, MD 20854
Provider Phone Number
(301) 299-2273
Provider SSA County
150
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
158
Number of Residents in Certified Beds
145
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE OF POTOMAC MD LLC
Date First Approved to Provide Medicare and Medicaid services
1988-06-24
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
1.97655
Reported LPN Staffing Hours per Resident per Day
0.67862
Reported RN Staffing Hours per Resident per Day
1.00931
Reported Licensed Staffing Hours per Resident per Day
1.68793
Reported Total Nurse Staffing Hours per Resident per Day
3.66448
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15069
Expected CNA Staffing Hours per Resident per Day
2.59797
Expected LPN Staffing Hours per Resident per Day
0.68811
Expected RN Staffing Hours per Resident per Day
1.18982
Expected Total Nurse Staffing Hours per Resident per Day
4.47590
Adjusted CNA Staffing Hours per Resident per Day
1.86679
Adjusted LPN Staffing Hours per Resident per Day
0.81855
Adjusted RN Staffing Hours per Resident per Day
0.63384
Adjusted Total Nurse Staffing Hours per Resident per Day
3.30015
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-08-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-09-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
16.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
5
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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