Bourne Manor Extended Care Facility - Bourne Nursing Home
General Information
UPDATEFederal Provider Number
225348
Provider Name
BOURNE MANOR EXTENDED CARE FACILITY
Provider Address
146 MAC ARTHUR BOULEVARD
BOURNE, MA 2532
BOURNE, MA 2532
Provider Phone Number
5087598880
Provider SSA County
0
Provider County Name
Barnstable
Ownership Type
Non profit - Corporation
Number of Certified Beds
142
Number of Residents in Certified Beds
136
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BOURNE MANOR NURSING, LLC
Date First Approved to Provide Medicare and Medicaid services
1989-08-09
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
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
1
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
2.32022
Reported LPN Staffing Hours per Resident per Day
0.80662
Reported RN Staffing Hours per Resident per Day
0.72574
Reported Licensed Staffing Hours per Resident per Day
1.53235
Reported Total Nurse Staffing Hours per Resident per Day
3.85258
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07574
Expected CNA Staffing Hours per Resident per Day
2.33316
Expected LPN Staffing Hours per Resident per Day
0.64105
Expected RN Staffing Hours per Resident per Day
1.01300
Expected Total Nurse Staffing Hours per Resident per Day
3.98721
Adjusted CNA Staffing Hours per Resident per Day
2.44010
Adjusted LPN Staffing Hours per Resident per Day
1.04437
Adjusted RN Staffing Hours per Resident per Day
0.53531
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89479
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
2015-03-24
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
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-02-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2012-11-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
22.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
2000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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