Sullivan County Health Care - Unity Nursing Home
General Information
UPDATEFederal Provider Number
305093
Provider Name
SULLIVAN COUNTY HEALTH CARE
Provider Address
5 NURSING HOME DRIVE
UNITY, NH 3743
UNITY, NH 3743
Provider Phone Number
6035429511
Provider SSA County
90
Provider County Name
Sullivan
Ownership Type
For profit - Corporation
Number of Certified Beds
156
Number of Residents in Certified Beds
139
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SULLIVAN COUNTY NURSING HOME
Date First Approved to Provide Medicare and Medicaid services
2002-09-15
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
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.61475
Reported LPN Staffing Hours per Resident per Day
1.05863
Reported RN Staffing Hours per Resident per Day
0.51475
Reported Licensed Staffing Hours per Resident per Day
1.57338
Reported Total Nurse Staffing Hours per Resident per Day
4.18813
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01403
Expected CNA Staffing Hours per Resident per Day
2.48096
Expected LPN Staffing Hours per Resident per Day
0.57661
Expected RN Staffing Hours per Resident per Day
0.87305
Expected Total Nurse Staffing Hours per Resident per Day
3.93063
Adjusted CNA Staffing Hours per Resident per Day
2.58602
Adjusted LPN Staffing Hours per Resident per Day
1.52383
Adjusted RN Staffing Hours per Resident per Day
0.44055
Adjusted Total Nurse Staffing Hours per Resident per Day
4.29497
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-07-30
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-08-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
6.66700
Number of Facility Reported Incidents
0
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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