Ballou Home For The Aged - Woonsocket Nursing Home
General Information
UPDATEFederal Provider Number
415094
Provider Name
BALLOU HOME FOR THE AGED
Provider Address
60 MENDON ROAD
WOONSOCKET, RI 2895
WOONSOCKET, RI 2895
Provider Phone Number
(401) 769-0437
Provider SSA County
30
Provider County Name
Providence
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
43
Number of Residents in Certified Beds
42
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BALLOU HOME FOR THE AGED OF WOONSOCKET RHODE ISLAND
Date First Approved to Provide Medicare and Medicaid services
1991-05-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.14881
Reported LPN Staffing Hours per Resident per Day
0.36190
Reported RN Staffing Hours per Resident per Day
1.11190
Reported Licensed Staffing Hours per Resident per Day
1.47381
Reported Total Nurse Staffing Hours per Resident per Day
4.62261
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03214
Expected CNA Staffing Hours per Resident per Day
2.12030
Expected LPN Staffing Hours per Resident per Day
0.53222
Expected RN Staffing Hours per Resident per Day
0.70521
Expected Total Nurse Staffing Hours per Resident per Day
3.35774
Adjusted CNA Staffing Hours per Resident per Day
3.64393
Adjusted LPN Staffing Hours per Resident per Day
0.56438
Adjusted RN Staffing Hours per Resident per Day
1.17810
Adjusted Total Nurse Staffing Hours per Resident per Day
5.54936
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
0
Cycle 1 Standard Survey Health Date
2014-12-19
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-02-12
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-12-21
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
0.00000
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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