Clipper Harbor - Portsmouth Nursing Home

General Information

UPDATE
Federal Provider Number
305082
Provider Name
CLIPPER HARBOR
Provider Address
188 JONES AVENUE
PORTSMOUTH, NH 3801
Provider Phone Number
(603) 431-2530
Provider SSA County
70
Provider County Name
Rockingham
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
102
Number of Residents in Certified Beds
87
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SUNBRIDGE CLIPPER HOME OF PORTSMOUTH, INC.
Date First Approved to Provide Medicare and Medicaid services
1997-02-12
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
4
Health Inspection Rating Footnote
QM Rating
1
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
2.30172
Reported LPN Staffing Hours per Resident per Day
0.47931
Reported RN Staffing Hours per Resident per Day
1.30517
Reported Licensed Staffing Hours per Resident per Day
1.78448
Reported Total Nurse Staffing Hours per Resident per Day
4.08620
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12299
Expected CNA Staffing Hours per Resident per Day
2.39706
Expected LPN Staffing Hours per Resident per Day
0.63501
Expected RN Staffing Hours per Resident per Day
1.04307
Expected Total Nurse Staffing Hours per Resident per Day
4.07513
Adjusted CNA Staffing Hours per Resident per Day
2.35611
Adjusted LPN Staffing Hours per Resident per Day
0.62649
Adjusted RN Staffing Hours per Resident per Day
0.93495
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04185
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
2014-06-11
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-06-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
6.00000
Number of Facility Reported Incidents
1
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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