Brookside Health And Rehabilitation - White River Junction Nursing Home
General Information
UPDATEFederal Provider Number
475010
Provider Name
BROOKSIDE HEALTH AND REHABILITATION
Provider Address
1200 CHRISTIAN STREET
WHITE RIVER JUNCTION, VT 5001
WHITE RIVER JUNCTION, VT 5001
Provider Phone Number
(802) 295-7511
Provider SSA County
130
Provider County Name
Windsor
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
67
Number of Residents in Certified Beds
63
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BROOKSIDE NURSING HOME
Date First Approved to Provide Medicare and Medicaid services
1967-04-13
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
2.57302
Reported LPN Staffing Hours per Resident per Day
0.70397
Reported RN Staffing Hours per Resident per Day
0.91190
Reported Licensed Staffing Hours per Resident per Day
1.61587
Reported Total Nurse Staffing Hours per Resident per Day
4.18889
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10000
Expected CNA Staffing Hours per Resident per Day
2.52390
Expected LPN Staffing Hours per Resident per Day
0.60981
Expected RN Staffing Hours per Resident per Day
1.02285
Expected Total Nurse Staffing Hours per Resident per Day
4.15655
Adjusted CNA Staffing Hours per Resident per Day
2.50145
Adjusted LPN Staffing Hours per Resident per Day
0.95816
Adjusted RN Staffing Hours per Resident per Day
0.66615
Adjusted Total Nurse Staffing Hours per Resident per Day
4.06226
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
20
Cycle 1 Standard Survey Health Date
2014-04-16
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
16
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
16
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-08-29
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
20.00000
Number of Facility Reported Incidents
9
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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