Maple Glen Center - Fairlawn Nursing Home
General Information
UPDATEFederal Provider Number
315328
Provider Name
MAPLE GLEN CENTER
Provider Address
12-15 SADDLE RIVER ROAD
FAIRLAWN, NJ 7410
FAIRLAWN, NJ 7410
Provider Phone Number
(201) 797-9522
Provider SSA County
100
Provider County Name
Bergen
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
161
Number of Residents in Certified Beds
149
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
12-15 SADDLE RIVER ROAD OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1993-11-01
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
4
QM Rating Footnote
Staffing Rating
3
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
2.13490
Reported LPN Staffing Hours per Resident per Day
0.38926
Reported RN Staffing Hours per Resident per Day
1.17013
Reported Licensed Staffing Hours per Resident per Day
1.55940
Reported Total Nurse Staffing Hours per Resident per Day
3.69429
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12248
Expected CNA Staffing Hours per Resident per Day
2.50673
Expected LPN Staffing Hours per Resident per Day
0.67491
Expected RN Staffing Hours per Resident per Day
1.11261
Expected Total Nurse Staffing Hours per Resident per Day
4.29425
Adjusted CNA Staffing Hours per Resident per Day
2.08974
Adjusted LPN Staffing Hours per Resident per Day
0.47871
Adjusted RN Staffing Hours per Resident per Day
0.78583
Adjusted Total Nurse Staffing Hours per Resident per Day
3.46773
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-10-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-09-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-11-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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