Eastside Center For Health & Rehabilitation, Llc - Bangor Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
205106
Provider Name
EASTSIDE CENTER FOR HEALTH & REHABILITATION, LLC
Provider Address
516 MT HOPE AVENUE
BANGOR, ME 4401
BANGOR, ME 4401
Provider Phone Number
(207) 947-6131
Provider SSA County
90
Provider County Name
Penobscot
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
67
Number of Residents in Certified Beds
66
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VK BANGOR LLC
Date First Approved to Provide Medicare and Medicaid services
1993-01-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
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
2.26742
Reported LPN Staffing Hours per Resident per Day
0.33409
Reported RN Staffing Hours per Resident per Day
0.78106
Reported Licensed Staffing Hours per Resident per Day
1.11515
Reported Total Nurse Staffing Hours per Resident per Day
3.38257
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07500
Expected CNA Staffing Hours per Resident per Day
2.51589
Expected LPN Staffing Hours per Resident per Day
0.62767
Expected RN Staffing Hours per Resident per Day
1.09469
Expected Total Nurse Staffing Hours per Resident per Day
4.23825
Adjusted CNA Staffing Hours per Resident per Day
2.21137
Adjusted LPN Staffing Hours per Resident per Day
0.44178
Adjusted RN Staffing Hours per Resident per Day
0.53313
Adjusted Total Nurse Staffing Hours per Resident per Day
3.21709
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
63
Cycle 1 Standard Survey Health Date
2015-02-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
63
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-03-06
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
10
Cycle 2 Total Health Score
30
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2013-03-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
50.16700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
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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