Van Dyk Manor Montclair - Montclair Nursing Home
General Information
UPDATEFederal Provider Number
315435
Provider Name
VAN DYK MANOR MONTCLAIR
Provider Address
42 NORTH MOUNTAIN AVE
MONTCLAIR, NJ 7042
MONTCLAIR, NJ 7042
Provider Phone Number
9737839400
Provider SSA County
200
Provider County Name
Essex
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VAN DYK HEALTH CARE INC
Date First Approved to Provide Medicare and Medicaid services
1998-06-15
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.70492
Reported LPN Staffing Hours per Resident per Day
0.80656
Reported RN Staffing Hours per Resident per Day
1.01721
Reported Licensed Staffing Hours per Resident per Day
1.82377
Reported Total Nurse Staffing Hours per Resident per Day
4.52869
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13607
Expected CNA Staffing Hours per Resident per Day
2.41109
Expected LPN Staffing Hours per Resident per Day
0.65719
Expected RN Staffing Hours per Resident per Day
1.21584
Expected Total Nurse Staffing Hours per Resident per Day
4.28411
Adjusted CNA Staffing Hours per Resident per Day
2.75273
Adjusted LPN Staffing Hours per Resident per Day
1.01865
Adjusted RN Staffing Hours per Resident per Day
0.62513
Adjusted Total Nurse Staffing Hours per Resident per Day
4.26102
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-07-16
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-06-27
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-06-18
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
20.66700
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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