Marian Manor - Boston Nursing Home
General Information
UPDATEFederal Provider Number
225415
Provider Name
MARIAN MANOR
Provider Address
130 DORCHESTER AVENUE
BOSTON, MA 2127
BOSTON, MA 2127
Provider Phone Number
6172683333
Provider SSA County
160
Provider County Name
Suffolk
Ownership Type
Non profit - Corporation
Number of Certified Beds
355
Number of Residents in Certified Beds
191
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MARIAN MANOR FOR THE AGED AND INFIRM INC
Date First Approved to Provide Medicare and Medicaid services
1990-07-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
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
2.82435
Reported LPN Staffing Hours per Resident per Day
0.46440
Reported RN Staffing Hours per Resident per Day
1.30105
Reported Licensed Staffing Hours per Resident per Day
1.76545
Reported Total Nurse Staffing Hours per Resident per Day
4.58980
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04738
Expected CNA Staffing Hours per Resident per Day
2.37293
Expected LPN Staffing Hours per Resident per Day
0.59939
Expected RN Staffing Hours per Resident per Day
0.85722
Expected Total Nurse Staffing Hours per Resident per Day
3.82953
Adjusted CNA Staffing Hours per Resident per Day
2.92049
Adjusted LPN Staffing Hours per Resident per Day
0.64308
Adjusted RN Staffing Hours per Resident per Day
1.13407
Adjusted Total Nurse Staffing Hours per Resident per Day
4.83114
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-11-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
3000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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