Marshall Lane Manor - Derby Nursing Home
General Information
UPDATEFederal Provider Number
75430
Provider Name
MARSHALL LANE MANOR
Provider Address
101 MARSHALL LANE
DERBY, CT 6418
DERBY, CT 6418
Provider Phone Number
2037343393
Provider SSA County
40
Provider County Name
New Haven
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
103
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SIMONETTI REALTY INC
Date First Approved to Provide Medicare and Medicaid services
2003-03-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.46311
Reported LPN Staffing Hours per Resident per Day
0.21845
Reported RN Staffing Hours per Resident per Day
0.63301
Reported Licensed Staffing Hours per Resident per Day
0.85146
Reported Total Nurse Staffing Hours per Resident per Day
2.31457
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00534
Expected CNA Staffing Hours per Resident per Day
1.95419
Expected LPN Staffing Hours per Resident per Day
0.53625
Expected RN Staffing Hours per Resident per Day
0.70183
Expected Total Nurse Staffing Hours per Resident per Day
3.19227
Adjusted CNA Staffing Hours per Resident per Day
1.83710
Adjusted LPN Staffing Hours per Resident per Day
0.33811
Adjusted RN Staffing Hours per Resident per Day
0.67393
Adjusted Total Nurse Staffing Hours per Resident per Day
2.92262
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-09-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-08-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
63.33300
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
Nursiong Homes Nearby
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