Vanderman Place - Willimantic Nursing Home
General Information
UPDATEFederal Provider Number
75425
Provider Name
VANDERMAN PLACE
Provider Address
595 VALLEY STREET
WILLIMANTIC, CT 6226
WILLIMANTIC, CT 6226
Provider Phone Number
8604507060
Provider SSA County
70
Provider County Name
Windham
Ownership Type
For profit - Corporation
Number of Certified Beds
124
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JACC HEALTHCARE CENTER OF WINDHAM LLC
Date First Approved to Provide Medicare and Medicaid services
2000-03-15
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
2.33158
Reported LPN Staffing Hours per Resident per Day
0.93895
Reported RN Staffing Hours per Resident per Day
0.56211
Reported Licensed Staffing Hours per Resident per Day
1.50105
Reported Total Nurse Staffing Hours per Resident per Day
3.83264
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14737
Expected CNA Staffing Hours per Resident per Day
2.25658
Expected LPN Staffing Hours per Resident per Day
0.61853
Expected RN Staffing Hours per Resident per Day
1.02481
Expected Total Nurse Staffing Hours per Resident per Day
3.89992
Adjusted CNA Staffing Hours per Resident per Day
2.53525
Adjusted LPN Staffing Hours per Resident per Day
1.25997
Adjusted RN Staffing Hours per Resident per Day
0.40984
Adjusted Total Nurse Staffing Hours per Resident per Day
3.96136
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-05-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
108
Cycle 2 Standard Health Survey Date
2013-07-10
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
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-06-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
93.33300
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
3
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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Colonial Health & Rehab Center Of Plainfield Llc
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