Country Village Center, Genesis Healthcare - Lancaster Nursing Home
General Information
UPDATEFederal Provider Number
305076
Provider Name
COUNTRY VILLAGE CENTER, GENESIS HEALTHCARE
Provider Address
91 COUNTRY VILLAGE ROAD
LANCASTER, NH 3584
LANCASTER, NH 3584
Provider Phone Number
(603) 788-4735
Provider SSA County
30
Provider County Name
Coos
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
86
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
91 COUNTRY VILLAGE ROAD OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1996-05-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
1.92024
Reported LPN Staffing Hours per Resident per Day
0.44405
Reported RN Staffing Hours per Resident per Day
0.99524
Reported Licensed Staffing Hours per Resident per Day
1.43929
Reported Total Nurse Staffing Hours per Resident per Day
3.35953
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07202
Expected CNA Staffing Hours per Resident per Day
2.38994
Expected LPN Staffing Hours per Resident per Day
0.62289
Expected RN Staffing Hours per Resident per Day
1.03892
Expected Total Nurse Staffing Hours per Resident per Day
4.05176
Adjusted CNA Staffing Hours per Resident per Day
1.97147
Adjusted LPN Staffing Hours per Resident per Day
0.59170
Adjusted RN Staffing Hours per Resident per Day
0.71578
Adjusted Total Nurse Staffing Hours per Resident per Day
3.34224
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-04-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
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
2013-03-06
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-01-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
16.66700
Number of Facility Reported Incidents
0
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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