Notre Dame Convalescent Home I - Norwalk Nursing Home
General Information
UPDATEFederal Provider Number
75356
Provider Name
NOTRE DAME CONVALESCENT HOME I
Provider Address
76 WEST ROCKS ROAD
NORWALK, CT 6851
NORWALK, CT 6851
Provider Phone Number
(203) 847-5893
Provider SSA County
0
Provider County Name
Fairfield
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NOTRE DAME CONVALESCENT HOME INC
Date First Approved to Provide Medicare and Medicaid services
1991-10-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
2.22155
Reported LPN Staffing Hours per Resident per Day
0.77155
Reported RN Staffing Hours per Resident per Day
0.80345
Reported Licensed Staffing Hours per Resident per Day
1.57500
Reported Total Nurse Staffing Hours per Resident per Day
3.79655
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02500
Expected CNA Staffing Hours per Resident per Day
2.64337
Expected LPN Staffing Hours per Resident per Day
0.58771
Expected RN Staffing Hours per Resident per Day
0.91544
Expected Total Nurse Staffing Hours per Resident per Day
4.14652
Adjusted CNA Staffing Hours per Resident per Day
2.06215
Adjusted LPN Staffing Hours per Resident per Day
1.08963
Adjusted RN Staffing Hours per Resident per Day
0.65579
Adjusted Total Nurse Staffing Hours per Resident per Day
3.69069
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-05-16
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-04-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
27.33300
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
0
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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