SIGNATURE HEALTHCARE AT MALLARD BAY
Address
520 GLENBURN AVENUE
CAMBRIDGE, MD 21613
(410) 228-9191
Nursing Home Ratings
Health Inspections | |
Quality Measures | |
Nursing Staff | |
R.N. Staff Only | |
Overall Rating |
Percent of Beds Occupied
Number of Residents and Certified Beds
- Residents: 114
- Certified Beds: 160
This Facility Accepts
- Medicare
- Medicaid
Operational Details
- Operated By For Profit - Corporation
- Offers Only Resident Counseling
- This Facility is Part of a Chain or Franchise
Resident Services
The information below lists services this facility has provided for residents from October through December 2010. During this period, the most common type of service provided was "Ultra-High Rehabilitation". To get a better idea of the types of services that are commonly performed, compare the "Percent of Service Days" column below. These services are based on submitted claims to Medicare and do not provide a complete overview of all the services provided by Signature Healthcare at Mallard Bay. For more information read our guide on how nursing facilities are reimbursed, types of services, and ADL index scores.
Resident Services | Resident Conditions | Percent of Service Days |
Very High Rehabilitation Plus Extensive Services
- At least one rehabilitation discipline five days/week
- Tracheostomy care
- Ventilator or respirator
- Isolation for active infectious disease while a resident
- Activities of Daily Living (ADL) score of 2 or more
ADL Index Range: 11-16 | 1.3% |
ADL Index Range: 2-10 | 2.3% |
Total Percent: | 3.6% |
Ultra-High Rehabilitation
- At least one rehabilitation discipline five days/week
- A second rehabilitation discipline three days/week
ADL Index Range: 11-16 | 24.8% |
ADL Index Range: 6-10 | 12.0% |
ADL Index Range: 0-5 | 11.5% |
Total Percent: | 48.3% |
Very High Rehabilitation
- At least one rehabilitation discipline five days/week
ADL Index Range: 11-16 | 7.1% |
ADL Index Range: 6-10 | 2.8% |
ADL Index Range: 0-5 | 6.7% |
Total Percent: | 16.6% |
High Rehabilitation
- At least one rehabilitation discipline five days/week
ADL Index Range: 11-16 | 4.7% |
ADL Index Range: 0-5 | 1.1% |
Total Percent: | 5.8% |
Medium Rehabilitation
- Five days any combination of three rehabilitation disciplines
ADL Index Range: 11-16 | 3.1% |
ADL Index Range: 6-10 | 5.8% |
Total Percent: | 8.8% |
Special Care High
- Comatose
- Septicemia
- Diabetes with daily injections and a change of order two or more days
- Quadriplegia with ADL score greater or equal to 5
- Chronic Obstructive Pulmonary Disease (COPD) and shortness of breath when lying flat
- Fever with pneumonia, or vomiting, or weight loss, or feeding tube
- Parenteral/IV feedings
- Respiratory therapy for 7 days
- Activities of Daily Living (ADL) score of 2 or more
ADL Index Range: 15-16 - No Signs of depression | 2.8% |
ADL Index Range: 11-14 - No Signs of depression | 0.5% |
ADL Index Range: 2-5 - No Signs of depression | 2.7% |
Total Percent: | 6.0% |
Special Care Low
- Cerebral palsy, multiple sclerosis, or Parkinson's disease with ADL score greater or equal to 5
- Respiratory failure and oxygen therapy while a resident
- Feeding tube where calories >= 51% or calories are in the range of 26-50% and fluid >= 501 mL)
- Ulcers: 2 or more stage II or 1 or more stage III or IV pressure ulcers
- Ulcers: 2 or more venous or arterial ulcers
- Ulcers: 1 stage II pressure ulcer and 1 venous or arterial ulcer with 2 or more skin care treatments
- Foot infection/diabetic foot ulcer/open lesions of foot with treatment
- Radiation therapy while a resident
- Dialysis while a resident
- Activities of Daily Living (ADL) score of 2 or more
ADL Index Range: 11-14 - No Signs of depression | 1.4% |
ADL Index Range: 6-10 - No Signs of depression | 1.3% |
ADL Index Range: 2-5 - No Signs of depression | 3.5% |
Total Percent: | 6.1% |
Clinically Complex
- Pneumonia, hemiplegia with ADL score >=5
- Surgical wounds or open lesions with treatment
- Burns
- Chemotherapy while a resident
- Oxygen therapy while a resident
- IV medications or transfusions while a resident
- Extensive Services, Special Care High or Special Care Low qualifier and ADL score of 0 or 1
ADL Index Range: 15-16 - No Signs of depression | 1.3% |
ADL Index Range: 11-14 - No Signs of depression | 1.4% |
ADL Index Range: 0-1 - No Signs of depression | 0.9% |
Total Percent: | 3.5% |
Reduced Physical Function
- Urinary and/or bowel training program
- Passive and/or active range of motion (ROM)
- Amputation/prosthesis training
- Dressing or grooming training
- Eating or swallowing training
- Transfer training
- Splint or brace assistance
- Bed mobility and/or walking training
- Communication training
ADL Index Range: 6-10 - Less restorative nursing | 1.3% |
Total Percent: | 1.3% |
Rating Details For Signature Healthcare at Mallard Bay
Nursing Staff -
The nursing staff is the most important part of what determines the quality of care and comfort of a resident in a nursing home. Government regulations set expectations on time spent with each resident based on the services being provided. The breakdown below lists the nursing types (RN, LPN, LVN, CNA) and a comparison of the reported and expected hours per resident per day.
Nursing Hours Per Resident Per Day | Reported | Expected |
Registered Nurse (RN) Hours | 1 Hour | 1 Hour and 3 Minutes |
Licensed Practical/Vocational Nurse (LPN/LVN) Hours | 24 Minutes | 41 Minutes |
Certified Nursing Assistant (CNA) Hours | 2 Hours and 8 Minutes | 2 Hours and 28 Minutes |
Total Licensed Nurse Hours | 1 Hour and 25 Minutes | 1 Hour and 44 Minutes |
Total Nurse Hours | 3 Hours and 32 Minutes | 4 Hours and 11 Minutes |
Quality of Care -
Medicare determines quality of care ratings for nursing facilities by surveying several "quality measures", which are broken down into long-term and short-term stay residents, as well as if the action is preventive or if there is a deficiency in the quality of care. State averages for Maryland are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.
This Facility | Maryland Average |
Long-Term Stay Preventive Actions
Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination | 90% | 87% |
Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season | 83% | 90% |
Long-Term Stay Deficiencies
Percent of Long-Stay Residents Who Were Physically Restrained | 1% | 4% |
Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased | 6% | 14% |
Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder | 3% | 4% |
Percent of Long-Stay Residents Who Had a Urinary Tract Infection | 4% | 9% |
Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores | - | 3% |
Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair | 13% | 7% |
Percent of Long-Stay Residents Who Have Moderate to Severe Pain | - | 2% |
Percent of Long-Stay Residents Who Lose Too Much Weight | 8% | 8% |
Percent of Long-Stay Residents Who Are More Depressed or Anxious | 5% | 9% |
Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder | 73% | 57% |
Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse | 7% | 11% |
Percent of High-Risk Long-Stay Residents Who Have Pressure Sores | 8% | 12% |
Short-Term Stay Preventive Actions
Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season | 55% | 80% |
Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination | 52% | 77% |
Short-Term Stay Deficiencies
Percent of Short-Stay Residents Who Had Moderate to Severe Pain | 6% | 14% |
Percent of Short-Stay Residents Who Have Pressure Sores | 12% | 13% |
Percent of Short-Stay Residents Who Have Delirium | - | 2% |
Health Inspection Details -
All Medicare and/or Medicaid certified nursing home must undergo health inspections on average once a year, but may be more frequent if the facility is peforming poorly. These inspections cover most aspects of life in a nursing home, and are broken down into deficiencies types, which including: Pharmacy Service, Administration, Resident Rights, Nutrition and Dietary, Resident Assessment, Environmental, and Mistreatment. Below are the list of deficiencies found by inspectors in the past few years along with the degree of harm and how many residents may have been affected. Note: The most recent health survey was on 01/27/2011.
Degree of Harm
- - Potential for Minimal Harm
- - Minimal Harm or Potential for Harm
- - Resident Harmed
- - Immediate Jeopardy to Resident Health
Residents Affected
- - Isolated
- - Some Residents
- - Many Residents
Deficiencies Found By Inspectors | Degree of Harm | Residents Affected |
Administration
Have a Detailed, Written Plan for Disasters and Emergencies.
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Give or Get Lab Tests to Meet the Needs of Residents.
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Environmental
Have Enough Outside Airflow.
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Nutrition and Dietary
Store, Cook, and Give out Food in a Safe and Clean Way.
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Pharmacy Service
1) Make Sure That Residents Who Take Drugs Are Not Given Too Many Doses or for Too Long; 2) Make Sure That the Use of Drugs is Carefully Watched; or 3) Stop or Change Drugs That Cause Unwanted Effects.
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1) Make Sure That Residents Who Take Drugs Are Not Given Too Many Doses or for Too Long; 2) Make Sure That the Use of Drugs is Carefully Watched; or 3) Stop or Change Drugs That Cause Unwanted Effects.
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Make Sure That Residents Are Safe from Serious Medication Errors.
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Quality Care
Make Sure That Each Resident's Nutritional Needs Were Met.
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Deficiencies from Complaints and Incidents
The table below lists incident reports by the nursing staff or administration for Signature Healthcare at Mallard Bay, as well as complaints by residents or their family in the previous three years.
Degree of Harm
- - Potential for Minimal Harm
- - Minimal Harm or Potential for Harm
- - Resident Harmed
- - Immediate Jeopardy to Resident Health
Residents Affected
- - Isolated
- - Some Residents
- - Many Residents
Formal Complaints | Degree of Harm | Residents Affected |
Administration
Get Services Outside the Nursing Home That Meet Professional Standards.
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Mistreatment
1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents.
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Pharmacy Service
Make Sure That Residents Are Safe from Serious Medication Errors.
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Quality Care
Make Sure That Each Resident's Nutritional Needs Were Met.
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Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible.
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Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores.
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Resident Rights
Immediately Tell the Resident, Doctor, and a Family Member If: the Resident is Injured, There is a Major Change in Resident's Physical/Mental Health, There is a Need to Alter Treatment Significantly, or the Resident Must Be Transferred or Discharged.
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Immediately Tell the Resident, Doctor, and a Family Member If: the Resident is Injured, There is a Major Change in Resident's Physical/Mental Health, There is a Need to Alter Treatment Significantly, or the Resident Must Be Transferred or Discharged.
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Provide Care in a Way That Keeps or Builds Each Resident's Dignity and Self Respect.
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Fire Safety
Nursing homes certified by Medicare and/or Medicaid are required to have fire safety inspections to meet Life Safety Code (LSC) standards. Below is a list of deficiencies that Signature Healthcare at Mallard Bay had in recent fire safety inspections. This information can be used to see if all standards were met, the degree of harm, the number of residents affected, and the date when deficiencies were corrected. Note: The most recent fire safety survey was on 01/12/2011.
Degree of Harm
- - Potential for Minimal Harm
- - Minimal Harm or Potential for Harm
- - Resident Harmed
- - Immediate Jeopardy to Resident Health
Residents Affected
- - Isolated
- - Some Residents
- - Many Residents
Deficiencies Found By Inspectors | Degree of Harm | Residents Affected |
Automatic Sprinkler Systems
An Approved Automatic Sprinkler System Connected to the Fire Alarm System.
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An Approved Automatic Sprinkler System Connected to the Fire Alarm System.
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An Approved Automatic Sprinkler System Connected to the Fire Alarm System.
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Building Service Equipment
Properly Protected Cooking Facilities.
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Corridor Walls and Doors
Corridor and Hallway Doors That Block Smoke.
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Corridor and Hallway Doors That Block Smoke.
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Electrical
A Separate and Independent Backup Electrical Power Source.
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Exits and Egress
Resident Room Doors of Proper Design and Width.
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Furnishings and Decorations
Exits That Are Free from Obstructions and Can Be Used at All Times.
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Hazardous Area
Construction That Can Resist Fire for One Hour or an Approved Fire Extinguishing System.
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Illumination and Emergency Power
Properly Located and Lighted "Exit" Signs.
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Interior Finish
Fire-Resistant Room Wall Surfaces.
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Medical Gases and Anesthetizing Areas
Proper Medical Gas Storage and Administration Areas.
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Miscellaneous
Fire Safety Features Required by Current Fire Safety Codes.
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Smoke Compartmentation and Control
Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour.
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Smoke Barrier Doors That Can Resist Smoke for at Least 20 Minutes.
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Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour.
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Smoke Barrier Doors That Can Resist Smoke for at Least 20 Minutes.
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Smoke Barrier Doors That Can Resist Smoke for at Least 20 Minutes.
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