Coos County Nursing Hospital - West Stewartstown Nursing Home
General Information
UPDATEFederal Provider Number
300000000000000000000000000000
Provider Name
COOS COUNTY NURSING HOSPITAL
Provider Address
136 COUNTY FARM ROAD
WEST STEWARTSTOWN, NH 3597
WEST STEWARTSTOWN, NH 3597
Provider Phone Number
6032463321
Provider SSA County
30
Provider County Name
Coos
Ownership Type
Government - County
Number of Certified Beds
97
Number of Residents in Certified Beds
72
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1979-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
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
4.43958
Reported LPN Staffing Hours per Resident per Day
0.49028
Reported RN Staffing Hours per Resident per Day
1.14514
Reported Licensed Staffing Hours per Resident per Day
1.63542
Reported Total Nurse Staffing Hours per Resident per Day
6.07500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00486
Expected CNA Staffing Hours per Resident per Day
2.52365
Expected LPN Staffing Hours per Resident per Day
0.62025
Expected RN Staffing Hours per Resident per Day
0.82084
Expected Total Nurse Staffing Hours per Resident per Day
3.96474
Adjusted CNA Staffing Hours per Resident per Day
4.31652
Adjusted LPN Staffing Hours per Resident per Day
0.65608
Adjusted RN Staffing Hours per Resident per Day
1.04241
Adjusted Total Nurse Staffing Hours per Resident per Day
6.17637
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-11-20
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
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-10-03
Cycle 2 Number of Health Revisits
1
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
8
Cycle 3 Standard Health Survey Date
2012-08-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
10.00000
Number of Facility Reported Incidents
2
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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