Coffman Nursing Home - Hagerstown Nursing Home
General Information
UPDATEFederal Provider Number
215352
Provider Name
COFFMAN NURSING HOME
Provider Address
1304 PENNSYLVANIA AVE
HAGERSTOWN, MD 21742
HAGERSTOWN, MD 21742
Provider Phone Number
(301) 733-2914
Provider SSA County
210
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COFFMAN NURSING HOME INC
Date First Approved to Provide Medicare and Medicaid services
2008-07-18
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
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.22328
Reported LPN Staffing Hours per Resident per Day
0.63103
Reported RN Staffing Hours per Resident per Day
0.44052
Reported Licensed Staffing Hours per Resident per Day
1.07155
Reported Total Nurse Staffing Hours per Resident per Day
4.29483
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02328
Expected CNA Staffing Hours per Resident per Day
2.74703
Expected LPN Staffing Hours per Resident per Day
0.64087
Expected RN Staffing Hours per Resident per Day
0.99615
Expected Total Nurse Staffing Hours per Resident per Day
4.38405
Adjusted CNA Staffing Hours per Resident per Day
2.87910
Adjusted LPN Staffing Hours per Resident per Day
0.81725
Adjusted RN Staffing Hours per Resident per Day
0.33043
Adjusted Total Nurse Staffing Hours per Resident per Day
3.94887
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-03-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
18
Cycle 2 Health Deficiency Score
203
Cycle 2 Standard Health Survey Date
2013-01-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
203
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2011-11-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
69.66700
Number of Facility Reported Incidents
8
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
128000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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