Colonial Poplin Nursing Home - Fremont Nursing Home
General Information
UPDATEFederal Provider Number
305091
Provider Name
COLONIAL POPLIN NURSING HOME
Provider Address
442 MAIN STREET
FREMONT, NH 3044
FREMONT, NH 3044
Provider Phone Number
(603) 895-3126
Provider SSA County
70
Provider County Name
Rockingham
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COLONIAL POPLIN NURSING HOME INC
Date First Approved to Provide Medicare and Medicaid services
1999-08-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.53372
Reported LPN Staffing Hours per Resident per Day
0.65233
Reported RN Staffing Hours per Resident per Day
0.58953
Reported Licensed Staffing Hours per Resident per Day
1.24186
Reported Total Nurse Staffing Hours per Resident per Day
3.77558
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10465
Expected CNA Staffing Hours per Resident per Day
2.48328
Expected LPN Staffing Hours per Resident per Day
0.57846
Expected RN Staffing Hours per Resident per Day
0.96123
Expected Total Nurse Staffing Hours per Resident per Day
4.02297
Adjusted CNA Staffing Hours per Resident per Day
2.50354
Adjusted LPN Staffing Hours per Resident per Day
0.93599
Adjusted RN Staffing Hours per Resident per Day
0.45826
Adjusted Total Nurse Staffing Hours per Resident per Day
3.78302
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-12-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
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
2013-12-31
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-03-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
10.66700
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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