Epoch Senior Health Care On Blackstone Boulevard - Providence Nursing Home
General Information
UPDATEFederal Provider Number
415126
Provider Name
EPOCH SENIOR HEALTH CARE ON BLACKSTONE BOULEVARD
Provider Address
353 BLACKSTONE BOULEVARD
PROVIDENCE, RI 2906
PROVIDENCE, RI 2906
Provider Phone Number
(401) 273-6565
Provider SSA County
30
Provider County Name
Providence
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
55
Number of Residents in Certified Beds
48
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
EPOCH ON BLACKSTONE BOULEVARD, LLC
Date First Approved to Provide Medicare and Medicaid services
1998-02-10
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
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.45833
Reported LPN Staffing Hours per Resident per Day
0.48333
Reported RN Staffing Hours per Resident per Day
1.80417
Reported Licensed Staffing Hours per Resident per Day
2.28750
Reported Total Nurse Staffing Hours per Resident per Day
4.74583
Reported Physical Therapist Staffing Hours per Resident Per Day
0.28542
Expected CNA Staffing Hours per Resident per Day
2.21154
Expected LPN Staffing Hours per Resident per Day
0.70300
Expected RN Staffing Hours per Resident per Day
1.62082
Expected Total Nurse Staffing Hours per Resident per Day
4.53536
Adjusted CNA Staffing Hours per Resident per Day
2.72751
Adjusted LPN Staffing Hours per Resident per Day
0.57065
Adjusted RN Staffing Hours per Resident per Day
0.83173
Adjusted Total Nurse Staffing Hours per Resident per Day
4.21796
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
8
Cycle 1 Standard Survey Health Date
2015-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-27
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
4.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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