Ledgewood Manor in Windham, ME - Medicare and Medicaid Certified Nursing Home

Ledgewood Manor is a medicare and medicaid certified nursing home in Windham, Maine. It is located in Cumberland county at 200 Route 115, Windham, Maine 04062. You can reach out to the office of Ledgewood Manor via phone at (207) 892-2261. This skilled nursing facility has 60 federally certified beds with average occupancy rate of 79.17%. Its legal business name is Ledgewood Manor Inc and has the following ownership type - For Profit - Individual.

Ledgewood Manor (Medicare CCN 205137) is certified by CMS (Centers for Medicare & Medicaid Services) and participates in both medicare and medicaid program. This means if you are part of medicare or medicaid program, you may consider this nursing facility for your medical needs. It was first certified by CMS in 1993 (33 years certified) and the last quality survey was conducted in February, 2025.

Contact Information

	Ledgewood Manor
	200 Route 115, Windham, Maine 04062
	(207) 892-2261

Map and Direction

Nursing Home Profile

Name	Ledgewood Manor
Location	200 Route 115, Windham, Maine
Certified By	Medicare and Medicaid
No. of Certified Beds	60
Occupancy Rate	79.17%
Medicare ID (CCN)	205137
Legal Business Name	Ledgewood Manor Inc
Ownership Type	For Profit - Individual

NPI Associated with this Nursing Home:

Nursing homes may have several NPI numbers. NPIs marked Confirmed are listed with Ledgewood Manor in Medicare enrollment records; Possible ones were matched in NPPES by name, address or phone number, so please use them accordingly.

NPI Number	1568522050
Match	Confirmed listed in Medicare enrollment records
Organization Name	Ledgewood Manor, Inc
Address	200 Tandberg Trl, Windham, ME 04062
Phone Number	207-892-2261

Quality Ratings:

Nursing homes vary in the quality of care and services they provide to their residents. The below quality ratings for Ledgewood Manor are calculated from three sources - health inspection results, staffing data, and quality measure data. This information gives you an indication of the care Ledgewood Manor give to their patients.

Ratings from Surveys (Inspections):
Ratings from Quality Measures:
Ratings from Staffing Data:
Overall Rating:

Staffing and Staff Turnover:

Staffing hours per resident per day and staff turnover of Ledgewood Manor, from the payroll data it reports to CMS, are compared against the national average with the color code indicators: Better than National Average Worse than National Average

Staffing Measure	Provider	National Avg.
Total nurse staff hours per resident per day	4.04	3.86
Registered nurse (RN) hours per resident per day	0.65	0.69
Licensed practical nurse (LPN) hours per resident per day	0.46	0.86
Nurse aide hours per resident per day	2.93	2.32
Total nurse staff hours per resident per day on the weekend	3.8	3.42
RN hours per resident per day on the weekend	0.52	0.48
Physical therapist hours per resident per day	0	0.07
Total nursing staff turnover	Not available: no valid staffing data was submitted	45.8%
Registered nurse turnover	Not available: no valid staffing data was submitted	42.9%
Number of administrators who have left the nursing home	Not available: no valid staffing data was submitted	0.5

Complaints, Fines and Penalties:

Cited for abuse, neglect or exploitation of residents (Care Compare abuse icon)	No
Number of Fines	0
Total Amount of Fines in Dollars	$0
Number of Payment Denials	0
Total Number of Penalties	0

Health Inspections:

In its most recent inspection cycle (standard health inspection in February, 2025, plus any complaint inspections), inspectors cited Ledgewood Manor for 10 health deficiencies (national average: 9.3). The 30 most recent of its 33 citations since 2019 are listed below.

Date	Deficiency	Harm Level	Status
Apr 29, 2025	Ensure services provided by the nursing facility meet professional standards of quality. F0658, Resident Assessment and Care Planning, Complaint inspection	Potential for harm, isolated	Past non-compliance (already corrected)
Feb 26, 2025	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. F0578, Resident Rights, Standard inspection	Potential for harm, pattern	Corrected by Apr 11, 2025
Feb 26, 2025	Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted F0655, Resident Assessment and Care Planning, Standard inspection	Potential for harm, pattern	Corrected by Apr 11, 2025
Feb 26, 2025	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. F0689, Quality of Life and Care, Standard inspection	Potential for harm, pattern	Corrected by Apr 11, 2025
Feb 26, 2025	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. F0755, Pharmacy Service, Standard inspection	Potential for harm, pattern	Corrected by Apr 11, 2025
Feb 26, 2025	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F0812, Nutrition and Dietary, Standard inspection	Potential for harm, pattern	Corrected by Apr 11, 2025
Feb 26, 2025	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. F0656, Resident Assessment and Care Planning, Standard inspection	Potential for harm, isolated	Corrected by Apr 11, 2025
Feb 26, 2025	Provide safe and appropriate respiratory care for a resident when needed. F0695, Quality of Life and Care, Standard inspection	Potential for harm, isolated	Corrected by Apr 11, 2025
Feb 26, 2025	Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. F0623, Resident Rights, Standard inspection	Minimal harm potential, pattern	Corrected by Apr 11, 2025
Feb 26, 2025	Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. F0625, Resident Rights, Standard inspection	Minimal harm potential, pattern	Corrected by Apr 11, 2025
Feb 26, 2025	Assess the resident when there is a significant change in condition F0637, Resident Assessment and Care Planning, Standard inspection	Minimal harm potential, pattern	Corrected by Apr 11, 2025
Oct 8, 2024	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. F0609, Freedom from Abuse, Neglect, and Exploitation, Complaint inspection	Potential for harm, isolated	Corrected by Nov 8, 2024
Jun 14, 2022	Provide and implement an infection prevention and control program. F0880, Infection Control, Standard inspection	Potential for harm, widespread	Corrected by Jun 29, 2022
Jun 14, 2022	Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. F0882, Infection Control, Standard inspection	Potential for harm, widespread	Corrected by Jun 29, 2022
Jun 14, 2022	Perform COVID19 testing on residents and staff. F0886, Infection Control, Standard inspection	Potential for harm, widespread	Corrected by Jun 29, 2022
Jun 14, 2022	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. F0657, Resident Assessment and Care Planning, Standard inspection	Potential for harm, pattern	Corrected by Jun 29, 2022
Jun 14, 2022	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F0812, Nutrition and Dietary, Standard inspection	Potential for harm, pattern	Corrected by Jun 29, 2022
Jun 14, 2022	Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. F0947, Nursing and Physician Services, Standard inspection	Potential for harm, pattern	Corrected by Jun 29, 2022
Jun 14, 2022	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. F0584, Resident Rights, Standard inspection	Potential for harm, isolated	Corrected by Jun 29, 2022
Jun 14, 2022	PASARR screening for Mental disorders or Intellectual Disabilities F0645, Resident Assessment and Care Planning, Standard inspection	Potential for harm, isolated	Corrected by Jun 29, 2022
Jun 14, 2022	Develop and implement policies and procedures for flu and pneumonia vaccinations. F0883, Infection Control, Standard inspection	Potential for harm, isolated	Corrected by Jun 29, 2022
Jun 14, 2022	Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. F0887, Infection Control, Standard inspection	Potential for harm, isolated	Corrected by Jun 29, 2022
Jun 14, 2022	Honor the resident's right to manage his or her financial affairs. F0567, Resident Rights, Standard inspection	Minimal harm potential, widespread	Corrected by Jun 29, 2022
Jun 14, 2022	Have the Quality Assessment and Assurance group have the required members and meet at least quarterly F0868, Administration, Standard inspection	Minimal harm potential, pattern	Corrected by Jun 29, 2022
Oct 31, 2019	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. F0689, Quality of Life and Care, Standard inspection	Immediate jeopardy, pattern	Corrected by Dec 31, 2019
Oct 31, 2019	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. F0657, Resident Assessment and Care Planning, Standard inspection	Potential for harm, pattern	Corrected by Dec 31, 2019
Oct 31, 2019	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. F0656, Resident Assessment and Care Planning, Standard inspection	Potential for harm, isolated	Corrected by Dec 31, 2019
Oct 31, 2019	Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. F0661, Resident Assessment and Care Planning, Standard inspection	Potential for harm, isolated	Corrected by Dec 31, 2019
Oct 31, 2019	Provide enough food/fluids to maintain a resident's health. F0692, Quality of Life and Care, Standard inspection	Potential for harm, isolated	Corrected by Dec 31, 2019
Oct 31, 2019	Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. F0838, Administration, Standard inspection	Potential for harm, isolated	Corrected by Dec 31, 2019

Quality of Resident Care:

These quality measures of Ledgewood Manor, from the regular health assessments of its residents, are compared against the national average with the color code indicators: Better than National Average Worse than National Average

Quality Measure	Provider	National Avg.
Percentage of long-stay residents whose need for help with daily activities has increased	32.31	13.87
Percentage of long-stay residents who lose too much weight	2.58	5.19
Percentage of long-stay residents with a catheter inserted and left in their bladder	6.23	0.82
Percentage of long-stay residents with a urinary tract infection	0	1.59
Percentage of long-stay residents who have depressive symptoms	12.4	12.8
Percentage of long-stay residents who were physically restrained	Not Available	0.13
Percentage of long-stay residents experiencing one or more falls with major injury	3.51	3.23
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	65.5	93.55
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	3.13	82.04
Percentage of short-stay residents who newly received an antipsychotic medication	Not Available	1.56
Percentage of long-stay residents whose ability to walk independently worsened	22.12	14.07
Percentage of long-stay residents who received an antianxiety or hypnotic medication	18.35	19.52
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	58.7	95.46
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	Not Available	79.75
Percentage of long-stay residents with pressure ulcers	1.98	4.62
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	36.72	19.01
Percentage of long-stay residents who received an antipsychotic medication	17.46	15.38

Reviews and Comments

Nursing Home

A nursing home (also called skilled nursing facility) is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living.

A skilled nursing facility (SNF) may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation.

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