Coleman House - Northborough Nursing Home
General Information
UPDATEFederal Provider Number
225403
Provider Name
COLEMAN HOUSE
Provider Address
112 WEST MAIN STREET
NORTHBOROUGH, MA 1532
NORTHBOROUGH, MA 1532
Provider Phone Number
(508) 351-9355
Provider SSA County
170
Provider County Name
Worcester
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GRANGERS NURSING HOME,INC
Date First Approved to Provide Medicare and Medicaid services
1990-07-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
2.44419
Reported LPN Staffing Hours per Resident per Day
0.73721
Reported RN Staffing Hours per Resident per Day
0.71279
Reported Licensed Staffing Hours per Resident per Day
1.45000
Reported Total Nurse Staffing Hours per Resident per Day
3.89419
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03372
Expected CNA Staffing Hours per Resident per Day
2.50245
Expected LPN Staffing Hours per Resident per Day
0.60254
Expected RN Staffing Hours per Resident per Day
0.95412
Expected Total Nurse Staffing Hours per Resident per Day
4.05911
Adjusted CNA Staffing Hours per Resident per Day
2.39658
Adjusted LPN Staffing Hours per Resident per Day
1.01551
Adjusted RN Staffing Hours per Resident per Day
0.55820
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86713
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-06-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-09-09
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-10-23
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
6.66700
Number of Facility Reported Incidents
1
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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