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Bloomfield Nursing And Rehab - Bloomfield Nursing Home

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Federal Provider Number
325066
Provider Name
BLOOMFIELD NURSING AND REHAB
Provider Address
803 HACIENDA LANE
BLOOMFIELD, NM 87413
Provider Phone Number
(505) 632-1823
Provider SSA County
220
Provider County Name
San Juan
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
95
Number of Residents in Certified Beds
87
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BLOOMFIELD HEALTH FACILITIES LP
Date First Approved to Provide Medicare and Medicaid services
1992-03-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
2.34080
Reported LPN Staffing Hours per Resident per Day
0.48333
Reported RN Staffing Hours per Resident per Day
0.63506
Reported Licensed Staffing Hours per Resident per Day
1.11839
Reported Total Nurse Staffing Hours per Resident per Day
3.45919
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01322
Expected CNA Staffing Hours per Resident per Day
2.29854
Expected LPN Staffing Hours per Resident per Day
0.61431
Expected RN Staffing Hours per Resident per Day
0.92766
Expected Total Nurse Staffing Hours per Resident per Day
3.84051
Adjusted CNA Staffing Hours per Resident per Day
2.49882
Adjusted LPN Staffing Hours per Resident per Day
0.65303
Adjusted RN Staffing Hours per Resident per Day
0.51152
Adjusted Total Nurse Staffing Hours per Resident per Day
3.63068
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-09-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-09-17
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
365
Cycle 3 Standard Health Survey Date
2012-09-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
365
Total Weighted Health Survey Score
108.83300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
7255
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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