Blueberry Hill Rehabilitation And Healthcare Ctr - Beverly Nursing Home
General Information
UPDATEFederal Provider Number
225133
Provider Name
BLUEBERRY HILL REHABILITATION AND HEALTHCARE CTR
Provider Address
75 BRIMBAL AVENUE
BEVERLY, MA 1915
BEVERLY, MA 1915
Provider Phone Number
(978) 927-2020
Provider SSA County
40
Provider County Name
Essex
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
132
Number of Residents in Certified Beds
121
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BLUEBERRY HILL OPERATOR LLC
Date First Approved to Provide Medicare and Medicaid services
1967-06-30
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
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
2.62810
Reported LPN Staffing Hours per Resident per Day
1.15744
Reported RN Staffing Hours per Resident per Day
0.87231
Reported Licensed Staffing Hours per Resident per Day
2.02975
Reported Total Nurse Staffing Hours per Resident per Day
4.65785
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06240
Expected CNA Staffing Hours per Resident per Day
2.42444
Expected LPN Staffing Hours per Resident per Day
0.63282
Expected RN Staffing Hours per Resident per Day
1.00652
Expected Total Nurse Staffing Hours per Resident per Day
4.06378
Adjusted CNA Staffing Hours per Resident per Day
2.65982
Adjusted LPN Staffing Hours per Resident per Day
1.51810
Adjusted RN Staffing Hours per Resident per Day
0.64757
Adjusted Total Nurse Staffing Hours per Resident per Day
4.62016
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-08-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-06-17
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
30
Cycle 2 Total Health Score
90
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-05-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
49.33300
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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