Montello Manor - Lewiston Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
205006
Provider Name
MONTELLO MANOR
Provider Address
540 COLLEGE ST
LEWISTON, ME 4240
LEWISTON, ME 4240
Provider Phone Number
(207) 783-2039
Provider SSA County
0
Provider County Name
Androscoggin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
57
Number of Residents in Certified Beds
36
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1971-07-16
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
2
QM Rating Footnote
Staffing Rating
4
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
2.76667
Reported LPN Staffing Hours per Resident per Day
0.28333
Reported RN Staffing Hours per Resident per Day
1.50694
Reported Licensed Staffing Hours per Resident per Day
1.79028
Reported Total Nurse Staffing Hours per Resident per Day
4.55694
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11944
Expected CNA Staffing Hours per Resident per Day
2.70688
Expected LPN Staffing Hours per Resident per Day
0.58755
Expected RN Staffing Hours per Resident per Day
0.89430
Expected Total Nurse Staffing Hours per Resident per Day
4.18873
Adjusted CNA Staffing Hours per Resident per Day
2.50790
Adjusted LPN Staffing Hours per Resident per Day
0.40024
Adjusted RN Staffing Hours per Resident per Day
1.25907
Adjusted Total Nurse Staffing Hours per Resident per Day
4.38523
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-02-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-02-26
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-05-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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