Berkshire Place - Providence Nursing Home

General Information

UPDATE
Federal Provider Number
415119
Provider Name
BERKSHIRE PLACE
Provider Address
455 DOUGLAS AVENUE
PROVIDENCE, RI 2908
Provider Phone Number
(401) 553-8600
Provider SSA County
30
Provider County Name
Providence
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
210
Number of Residents in Certified Beds
193
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BERKSHIRE PLACE LTD.
Date First Approved to Provide Medicare and Medicaid services
1995-05-03
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.27228
Reported LPN Staffing Hours per Resident per Day
0.39896
Reported RN Staffing Hours per Resident per Day
0.52668
Reported Licensed Staffing Hours per Resident per Day
0.92565
Reported Total Nurse Staffing Hours per Resident per Day
3.19792
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02953
Expected CNA Staffing Hours per Resident per Day
2.26751
Expected LPN Staffing Hours per Resident per Day
0.57896
Expected RN Staffing Hours per Resident per Day
0.95832
Expected Total Nurse Staffing Hours per Resident per Day
3.80480
Adjusted CNA Staffing Hours per Resident per Day
2.45886
Adjusted LPN Staffing Hours per Resident per Day
0.57195
Adjusted RN Staffing Hours per Resident per Day
0.41065
Adjusted Total Nurse Staffing Hours per Resident per Day
3.38796
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
2015-03-13
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
5
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-12-20
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
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
12
Cycle 3 Standard Health Survey Date
2012-12-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
8.66700
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
1
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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