Monmouth Co Care Jl Montgomery - Freehold Nursing Home
General Information
UPDATEFederal Provider Number
315387
Provider Name
MONMOUTH CO CARE JL MONTGOMERY
Provider Address
115 DUTCHLANE ROAD
FREEHOLD, NJ 7728
FREEHOLD, NJ 7728
Provider Phone Number
(732) 431-7420
Provider SSA County
290
Provider County Name
Monmouth
Provider Website
Provider Description
Ownership Type
Government - City/county
Number of Certified Beds
174
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY TREAS COUNTY OF MONMOUTH NJ
Date First Approved to Provide Medicare and Medicaid services
1998-03-02
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
3.07990
Reported LPN Staffing Hours per Resident per Day
0.99853
Reported RN Staffing Hours per Resident per Day
0.80735
Reported Licensed Staffing Hours per Resident per Day
1.80588
Reported Total Nurse Staffing Hours per Resident per Day
4.88578
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05588
Expected CNA Staffing Hours per Resident per Day
2.36100
Expected LPN Staffing Hours per Resident per Day
0.70749
Expected RN Staffing Hours per Resident per Day
1.05729
Expected Total Nurse Staffing Hours per Resident per Day
4.12578
Adjusted CNA Staffing Hours per Resident per Day
3.20083
Adjusted LPN Staffing Hours per Resident per Day
1.17143
Adjusted RN Staffing Hours per Resident per Day
0.57056
Adjusted Total Nurse Staffing Hours per Resident per Day
4.77342
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-11-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
2012-08-23
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
5.33300
Number of Facility Reported Incidents
1
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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