Watertown Convalarium, Inc - Watertown Nursing Home
General Information
UPDATEFederal Provider Number
75340
Provider Name
WATERTOWN CONVALARIUM, INC
Provider Address
560 WOODBURY ROAD
WATERTOWN, CT 6795
WATERTOWN, CT 6795
Provider Phone Number
(860) 274-6748
Provider SSA County
20
Provider County Name
Litchfield
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MVM INC
Date First Approved to Provide Medicare and Medicaid services
1990-09-14
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
1
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.47442
Reported LPN Staffing Hours per Resident per Day
0.32209
Reported RN Staffing Hours per Resident per Day
1.31977
Reported Licensed Staffing Hours per Resident per Day
1.64186
Reported Total Nurse Staffing Hours per Resident per Day
4.11628
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.26520
Expected LPN Staffing Hours per Resident per Day
0.52779
Expected RN Staffing Hours per Resident per Day
0.73264
Expected Total Nurse Staffing Hours per Resident per Day
3.52564
Adjusted CNA Staffing Hours per Resident per Day
2.68033
Adjusted LPN Staffing Hours per Resident per Day
0.50651
Adjusted RN Staffing Hours per Resident per Day
1.34599
Adjusted Total Nurse Staffing Hours per Resident per Day
4.70618
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-05-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-06-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
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
36
Cycle 3 Standard Health Survey Date
2012-05-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
28.66700
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
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