Good Shepherd Rehabilitation And Nursing Center - Jaffrey Nursing Home
General Information
UPDATEFederal Provider Number
305072
Provider Name
GOOD SHEPHERD REHABILITATION AND NURSING CENTER
Provider Address
20 PLANTATION DRIVE
JAFFREY, NH 3452
JAFFREY, NH 3452
Provider Phone Number
(603) 532-8762
Provider SSA County
20
Provider County Name
Cheshire
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
83
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SHEPHERD REHABILITATION AND NURSING CENTER
Date First Approved to Provide Medicare and Medicaid services
1996-04-01
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
4
Health Inspection Rating Footnote
QM Rating
4
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
1.03235
Reported LPN Staffing Hours per Resident per Day
0.58824
Reported RN Staffing Hours per Resident per Day
1.05515
Reported Licensed Staffing Hours per Resident per Day
1.64338
Reported Total Nurse Staffing Hours per Resident per Day
2.67574
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08015
Expected CNA Staffing Hours per Resident per Day
2.37836
Expected LPN Staffing Hours per Resident per Day
0.63238
Expected RN Staffing Hours per Resident per Day
0.94614
Expected Total Nurse Staffing Hours per Resident per Day
3.95689
Adjusted CNA Staffing Hours per Resident per Day
1.06505
Adjusted LPN Staffing Hours per Resident per Day
0.77206
Adjusted RN Staffing Hours per Resident per Day
0.83329
Adjusted Total Nurse Staffing Hours per Resident per Day
2.72579
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
2014-09-05
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
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
2013-06-27
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-05-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
5.33300
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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