Provider Name: PILGRIM MANOR
Address: 52 MISSIONARY RD, CROMWELL, CT 06416
Phone: (860) 635-5511
County: Middlesex (030)
Ownership Type: Non profit - Church related
Certified Beds: 60
Average Residents Per Day: 52.4 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: COVENANT HOME, INC. CONNECTICUT
First Approved Date: February 1, 1987
Affiliated Entity: COVENANT LIVING (168)
Retirement Community: Y, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 4 ()
QM Rating: 5 ()
Long Stay QM Rating: 5 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.37135, LPN Staff Hours Per Day: 0.7615, RN Staff Hours Per Day: 0.8035, Licensed Staff Hours Per Day: 1.5650
Total Nurse Staff Hours Per Day, per resident: 3.93638
Weekend Nurse Staff Hours: 3.59068, Weekend RN Staff Hours: 0.6091
PT Staff Hours Per Day, per resident: 0.0487
Nurse Staff Turnover: 19.1, Nurse Turnover Note:
RN Turnover: 9.1, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.0980, Case Mix LPN Hours Per Day: 0.6270, Case Mix RN Hours Per Day: 0.2723
Adjusted Nurse Aide Hours Per Day, per resident: 2.30264, Adjusted LPN Hours Per Day: 0.8963, Adjusted RN Hours Per Day: 1.1116
Total Adjusted Nurse Hours Per Day, per resident: 4.13944
Adjusted Weekend Nurse Hours Per Day, per resident: 3.77591
Health Survey Dates and Scores: Cycle 1: 2019-03-07 (Score: 12), Cycle 2: 2018-03-22 (Score: 24), Cycle 3: 2017-05-04 (Score: 32)
Total Weighted Health Score: 19.333
Reported Incidents: 1, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 52 MISSIONARY RD,CROMWELL,CT,06416 (41.6008, -72.658)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-06-07
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-03-27
Type: Health, Deficiency: Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-04-27
Type: Health, Deficiency: Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-04-27
Type: Health, Deficiency: Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-04-27
Type: Health, Deficiency: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-04-27
Type: Health, Deficiency: Allow residents the right to participate in the planning or revision of care and treatment.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2017-06-02
Type: Health, Deficiency: Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
Severity: G - Level 3: Actual harm that is not immediate jeopardy. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2017-06-02
Type: Health, Deficiency: Keep all essential equipment working safely.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2017-06-02
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0133, Version: New
Description: Install a two-hour-resistant firewall separation.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2017-06-29
Type: Fire Safety, Tag: 0712, Version: New
Description: Have simulated fire drills held at unexpected times.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2017-06-29
Type: Fire Safety, Tag: 0911, Version: New
Description: Meet requirements for the installation and maintenance of electrical systems.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2017-06-29