Cherry Hill Manor - Johnston Nursing Home
General Information
UPDATEFederal Provider Number
415053
Provider Name
CHERRY HILL MANOR
Provider Address
2 CHERRY HILL ROAD
JOHNSTON, RI 2919
JOHNSTON, RI 2919
Provider Phone Number
(401) 231-3102
Provider SSA County
30
Provider County Name
Providence
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
170
Number of Residents in Certified Beds
162
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIFE CARE CENTERS OF AMERICA, INC.
Date First Approved to Provide Medicare and Medicaid services
1977-08-01
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
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.32840
Reported LPN Staffing Hours per Resident per Day
0.48704
Reported RN Staffing Hours per Resident per Day
1.14969
Reported Licensed Staffing Hours per Resident per Day
1.63673
Reported Total Nurse Staffing Hours per Resident per Day
3.96513
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10123
Expected CNA Staffing Hours per Resident per Day
2.56490
Expected LPN Staffing Hours per Resident per Day
0.63638
Expected RN Staffing Hours per Resident per Day
1.04790
Expected Total Nurse Staffing Hours per Resident per Day
4.24918
Adjusted CNA Staffing Hours per Resident per Day
2.22745
Adjusted LPN Staffing Hours per Resident per Day
0.63523
Adjusted RN Staffing Hours per Resident per Day
0.81978
Adjusted Total Nurse Staffing Hours per Resident per Day
3.76144
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-11-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-12-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
11.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
2
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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