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Carroll Manor Nursing & Rehab

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About Carroll Manor Nursing & Rehab

General Information

Legal Business NameProvidence Hospital
Ownership TypeNon Profit - Corporation
Changed Ownership In The Last 12 MonthsNo
First Accepted MedicareMarch 20, 1996 (21 years)
Capacity252
Residents241
Percent Occupied96%
Program ParticipationMedicare And Medicaid
Resident And Family CouncilsBoth
In HospitalYes
Continuing Care Retirement CommunityNo
Special Focus FacilityNo
Auto Sprinkler System In Required AreasYes

Ratings for Carroll Manor Nursing & Rehab

Carroll Manor Nursing & Rehab
was reviewed by Medicare to have a rating of 5 out of 5. About Medicare Ratings
Overall Rating
Health Inspections Rating
Quality Measures Rating
Staff Rating
RN Staff Rating

Overall Ratings of Washington D.C. Nursing Homes

Fines, Complaints, and Inspection Problems in the Past 3 Years

Compare The Number of Problems

Types of Problems at Nursing Homes

Some issues within a nursing home are much more severe than others. Medicare evaluates each problem based on 2 scales: the number of residents affected by a problem and the severity of the potential or actual harm to residents based on the problem. We have color coded the matrix below to make it easier to pick out the more severe problems. In general, orange and red issues related to the treatment of a resident are considered substandard quality of care.

  Residents Affected
Severity of the Deficiency Few Some Many
Immediate jeopardy to resident health or safety J K L
Actual harm that is not immediate jeopardy G H I
No actual harm with potential for more than minimal harm that is not immediate jeopardy D E F
No actual harm with potential for minimal harm A B C

September 9, 2015 - 15 months ago

 Residents AffectedSeveritySource/TypeDescription
FManyPotential for HarmFire Safety InspectionAutomatic sprinkler systems that have been maintained in working order.
FManyPotential for HarmFire Safety InspectionA fire alarm system that can be heard throughout the facility.
FManyPotential for HarmFire Safety InspectionRecord of quarterly fire drills for each shift under varying conditions.
ESomePotential for HarmFire Safety InspectionOther fire safety features required by fire safety codes.
ESomePotential for HarmFire Safety InspectionCorridor and hallway doors that block smoke.
ESomePotential for HarmFire Safety InspectionProperly located and lighted "Exit" signs.
DFewPotential for HarmFire Safety InspectionRestrictions on the use of highly flammable decorations.
DFewPotential for HarmFire Safety InspectionFire resistant room wall surfaces.

August 24, 2015 - 16 months ago

 Residents AffectedSeveritySource/TypeDescription
GFewActual HarmComplaintEnsure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
DFewPotential for HarmComplaintProvide necessary care and services to maintain or improve the highest well being of each resident .
DFewPotential for HarmComplaintAllow residents the right to participate in the planning or revision of care and treatment.

July 24, 2015 - 17 months ago

 Residents AffectedSeveritySource/TypeDescription
ESomePotential for HarmHealth InspectionStore, cook, and serve food in a safe and clean way.
ESomePotential for HarmHealth InspectionConduct initial and periodic assessments of each resident's functional capacity.
DFewPotential for HarmHealth InspectionKeep all essential equipment working safely.
DFewPotential for HarmHealth InspectionDevelop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

February 23, 2015 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
GFewActual HarmComplaintEnsure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
DFewPotential for HarmComplaintKeep accurate, complete and organized clinical records on each resident that meet professional standards.

October 7, 2014 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
ESomePotential for HarmFire Safety InspectionOther fire safety features required by fire safety codes.
ESomePotential for HarmFire Safety InspectionAutomatic sprinkler systems that have been maintained in working order.

September 16, 2014 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
---Fine$4,550 fine
GFewActual HarmHealth InspectionEnsure services provided by the nursing facility meet professional standards of quality.
GFewActual HarmHealth InspectionProvide necessary care and services to maintain or improve the highest well being of each resident .
ESomePotential for HarmHealth InspectionEnsure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
DFewPotential for HarmHealth InspectionHave a program that investigates, controls and keeps infection from spreading.
DFewPotential for HarmHealth InspectionKeep all essential equipment working safely.
DFewPotential for HarmHealth InspectionStore, cook, and serve food in a safe and clean way.
DFewPotential for HarmHealth InspectionAllow residents the right to participate in the planning or revision of care and treatment.
DFewPotential for HarmHealth InspectionGive residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.
DFewPotential for HarmHealth InspectionConduct initial and periodic assessments of each resident's functional capacity.

Staffing Levels Per Resident per Day

Medicare determines the expected staffing time per resident per day depending on level of care the residents of Carroll Manor Nursing & Rehab require. It is important to compare the reported time to expected time for a single facility instead of comparing the amount of time per resident of two facilities. Learn why.

2hr 25min
2hr 30min
ReportedExpected
CNA
1hr 10min
35min
ReportedExpected
LPN
60min
55min
ReportedExpected
RN
4hr 35min
4hr
ReportedExpected
Total Nursing

This facility also provides approximately 1hr 15min per resident per WEEK of physical therapist time.

Quality Measures for Long Stay Residents

100.0%
96.9%
96.9%
95.4%
Q1 2015Q2 2015Q3 2015DC
Assessed and Appropriately Given the Seasonal Influenza Vaccine
98.6%
100.0%
99.1%
88.8%
Q1 2015Q2 2015Q3 2015DC
Assessed and Appropriately Given the Pneumococcal Vaccine
66.7%
64.2%
75.0%
54.4%
Q1 2015Q2 2015Q3 2015DC
Low Risk Residents Who Lose Control of Their Bowel or Bladder
13.9%
14.7%
13.8%
13.7%
Q1 2015Q2 2015Q3 2015DC
Received an Antipsychotic Medication
20.7%
8.2%
8.8%
14.2%
Q1 2015Q2 2015Q3 2015DC
Need for Help with ADLs has Increased
0.5%
1.3%
0.7%
1.8%
Q1 2015Q2 2015Q3 2015DC
Self Report Moderate to Severe Pain
7.7%
6.2%
4.3%
6.7%
Q1 2015Q2 2015Q3 2015DC
Lose Too Much Weight
8.3%
8.2%
5.7%
9.2%
Q1 2015Q2 2015Q3 2015DC
High Risk Residents With Pressure Ulcers
1.6%
0.0%
0.5%
2.1%
Q1 2015Q2 2015Q3 2015DC
Have Depressive Symptoms
5.3%
2.4%
2.9%
4.8%
Q1 2015Q2 2015Q3 2015DC
With a Urinary Tract Infection
0.5%
0.9%
1.4%
1.0%
Q1 2015Q2 2015Q3 2015DC
Experiencing One or More Falls with Major Injury
0.4%
0.8%
0.4%
1.0%
Q1 2015Q2 2015Q3 2015DC
With a Catheter Inserted and Left in Their Bladder
0.0%
0.0%
0.0%
0.3%
Q1 2015Q2 2015Q3 2015DC
Were Physically Restrained

Quality Measures for Short Stay Residents

95.3%
96.1%
95.9%
72.5%
Q1 2015Q2 2015Q3 2015DC
Assessed and Appropriately Given the Pneumococcal Vaccine
96.5%
95.7%
95.7%
76.0%
Q1 2015Q2 2015Q3 2015DC
Were Assessed and Appropriately Given the Seasonal Influenza Vaccine
11.9%
4.0%
2.9%
9.4%
Q1 2015Q2 2015Q3 2015DC
Self Report Moderate to Severe Pain
1.4%
0.9%
0.4%
1.4%
Q1 2015Q2 2015Q3 2015DC
Newly Received an Antipsychotic Medication
0.8%
0.6%
0.5%
1.0%
Q1 2015Q2 2015Q3 2015DC
With Pressure Ulcers That Are New or Worsened