Montowese Health & Rehab Ctr, - North Haven Nursing Home
General Information
UPDATEFederal Provider Number
75017
Provider Name
MONTOWESE HEALTH & REHAB CTR,
Provider Address
163 QUINNIPIAC AVE
NORTH HAVEN, CT 6473
NORTH HAVEN, CT 6473
Provider Phone Number
2036243303
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
113
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MONTOWESE HEALTH & REHABILILTATION CENTER
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
3
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
2.42655
Reported LPN Staffing Hours per Resident per Day
0.93496
Reported RN Staffing Hours per Resident per Day
1.19469
Reported Licensed Staffing Hours per Resident per Day
2.12965
Reported Total Nurse Staffing Hours per Resident per Day
4.55620
Reported Physical Therapist Staffing Hours per Resident Per Day
0.49115
Expected CNA Staffing Hours per Resident per Day
2.75283
Expected LPN Staffing Hours per Resident per Day
0.87481
Expected RN Staffing Hours per Resident per Day
1.72253
Expected Total Nurse Staffing Hours per Resident per Day
5.35017
Adjusted CNA Staffing Hours per Resident per Day
2.16288
Adjusted LPN Staffing Hours per Resident per Day
0.88707
Adjusted RN Staffing Hours per Resident per Day
0.51823
Adjusted Total Nurse Staffing Hours per Resident per Day
3.43271
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2015-01-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2014-04-24
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-05-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
62.00000
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
4
Number of Fines
3
Total Amount of Fines in Dollars
5115
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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