Bayberry Commons - Pascoag Nursing Home
General Information
UPDATEFederal Provider Number
415080
Provider Name
BAYBERRY COMMONS
Provider Address
181 DAVIS DRIVE
PASCOAG, RI 2859
PASCOAG, RI 2859
Provider Phone Number
(401) 568-0600
Provider SSA County
30
Provider County Name
Providence
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
110
Number of Residents in Certified Beds
104
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BURRILLVILLE HEALTH CENTER
Date First Approved to Provide Medicare and Medicaid services
1985-04-11
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.44087
Reported LPN Staffing Hours per Resident per Day
0.40721
Reported RN Staffing Hours per Resident per Day
0.65240
Reported Licensed Staffing Hours per Resident per Day
1.05962
Reported Total Nurse Staffing Hours per Resident per Day
3.50048
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08365
Expected CNA Staffing Hours per Resident per Day
2.38460
Expected LPN Staffing Hours per Resident per Day
0.57125
Expected RN Staffing Hours per Resident per Day
0.89511
Expected Total Nurse Staffing Hours per Resident per Day
3.85096
Adjusted CNA Staffing Hours per Resident per Day
2.51160
Adjusted LPN Staffing Hours per Resident per Day
0.59166
Adjusted RN Staffing Hours per Resident per Day
0.54459
Adjusted Total Nurse Staffing Hours per Resident per Day
3.66404
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-10-27
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-11-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-10-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
3.33300
Number of Facility Reported Incidents
1
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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