Monticello House - Media Nursing Home
General Information
UPDATEFederal Provider Number
395974
Provider Name
MONTICELLO HOUSE
Provider Address
1048 W BALTIMORE AVENUE
MEDIA, PA 19063
MEDIA, PA 19063
Provider Phone Number
(610) 891-3803
Provider SSA County
290
Provider County Name
Delaware
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
86
Number of Residents in Certified Beds
77
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
RIDDLE VILLAGE
Date First Approved to Provide Medicare and Medicaid services
1995-11-13
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
2.70130
Reported LPN Staffing Hours per Resident per Day
0.83117
Reported RN Staffing Hours per Resident per Day
1.21104
Reported Licensed Staffing Hours per Resident per Day
2.04221
Reported Total Nurse Staffing Hours per Resident per Day
4.74351
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16299
Expected CNA Staffing Hours per Resident per Day
2.56250
Expected LPN Staffing Hours per Resident per Day
0.63061
Expected RN Staffing Hours per Resident per Day
1.06373
Expected Total Nurse Staffing Hours per Resident per Day
4.25684
Adjusted CNA Staffing Hours per Resident per Day
2.58660
Adjusted LPN Staffing Hours per Resident per Day
1.09398
Adjusted RN Staffing Hours per Resident per Day
0.85067
Adjusted Total Nurse Staffing Hours per Resident per Day
4.49174
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
28
Cycle 1 Standard Survey Health Date
2014-11-17
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-11-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2013-01-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
1
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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