Blaire House Of Tewksbury - Tewksbury Nursing Home
General Information
UPDATEFederal Provider Number
225548
Provider Name
BLAIRE HOUSE OF TEWKSBURY
Provider Address
10 ERLIN TERRACE
TEWKSBURY, MA 1876
TEWKSBURY, MA 1876
Provider Phone Number
9788513121
Provider SSA County
90
Provider County Name
Middlesex
Ownership Type
For profit - Corporation
Number of Certified Beds
131
Number of Residents in Certified Beds
119
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ERLIN MANOR NURSING HOME INC
Date First Approved to Provide Medicare and Medicaid services
1992-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
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
2.40126
Reported LPN Staffing Hours per Resident per Day
0.93529
Reported RN Staffing Hours per Resident per Day
0.58613
Reported Licensed Staffing Hours per Resident per Day
1.52143
Reported Total Nurse Staffing Hours per Resident per Day
3.92268
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04160
Expected CNA Staffing Hours per Resident per Day
2.43468
Expected LPN Staffing Hours per Resident per Day
0.58349
Expected RN Staffing Hours per Resident per Day
0.85855
Expected Total Nurse Staffing Hours per Resident per Day
3.87672
Adjusted CNA Staffing Hours per Resident per Day
2.42002
Adjusted LPN Staffing Hours per Resident per Day
1.33043
Adjusted RN Staffing Hours per Resident per Day
0.51011
Adjusted Total Nurse Staffing Hours per Resident per Day
4.07869
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-07-21
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-06-12
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-06-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
3000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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