Shady Lane Gloucester Co Home - Clarksboro Nursing Home
General Information
UPDATEFederal Provider Number
315405
Provider Name
SHADY LANE GLOUCESTER CO HOME
Provider Address
256 COUNTY HOUSE ROAD
CLARKSBORO, NJ 8020
CLARKSBORO, NJ 8020
Provider Phone Number
8562246979
Provider SSA County
220
Provider County Name
Gloucester
Ownership Type
Government - County
Number of Certified Beds
60
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF GLOUCESTER
Date First Approved to Provide Medicare and Medicaid services
1997-12-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.65439
Reported LPN Staffing Hours per Resident per Day
1.08246
Reported RN Staffing Hours per Resident per Day
0.60175
Reported Licensed Staffing Hours per Resident per Day
1.68421
Reported Total Nurse Staffing Hours per Resident per Day
3.33860
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.37873
Expected LPN Staffing Hours per Resident per Day
0.63989
Expected RN Staffing Hours per Resident per Day
0.98672
Expected Total Nurse Staffing Hours per Resident per Day
4.00533
Adjusted CNA Staffing Hours per Resident per Day
1.70653
Adjusted LPN Staffing Hours per Resident per Day
1.40406
Adjusted RN Staffing Hours per Resident per Day
0.45568
Adjusted Total Nurse Staffing Hours per Resident per Day
3.35991
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
2014-12-19
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-02-12
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-04-02
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
22.00000
Number of Facility Reported Incidents
1
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
Nursiong Homes Nearby
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Kennedy Health Care Center
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SEWELL NJ 8080 | 8.8 miles away
Manorcare Health Services-washington Township
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SEWELL NJ 8080 | 10.4 miles away
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