Hallworth House - Providence Nursing Home
General Information
UPDATEFederal Provider Number
415024
Provider Name
HALLWORTH HOUSE
Provider Address
66 BENEFIT STREET
PROVIDENCE, RI 2904
PROVIDENCE, RI 2904
Provider Phone Number
(401) 274-4505
Provider SSA County
30
Provider County Name
Providence
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
57
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EPISCOPAL HOUSING FOUNDATION OF RHODE ISLAND
Date First Approved to Provide Medicare and Medicaid services
1968-07-17
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.96429
Reported LPN Staffing Hours per Resident per Day
0.59821
Reported RN Staffing Hours per Resident per Day
0.94018
Reported Licensed Staffing Hours per Resident per Day
1.53839
Reported Total Nurse Staffing Hours per Resident per Day
4.50268
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03571
Expected CNA Staffing Hours per Resident per Day
2.61975
Expected LPN Staffing Hours per Resident per Day
0.67668
Expected RN Staffing Hours per Resident per Day
1.11965
Expected Total Nurse Staffing Hours per Resident per Day
4.41608
Adjusted CNA Staffing Hours per Resident per Day
2.77641
Adjusted LPN Staffing Hours per Resident per Day
0.73375
Adjusted RN Staffing Hours per Resident per Day
0.62743
Adjusted Total Nurse Staffing Hours per Resident per Day
4.10995
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-08-22
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
2013-08-19
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
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-06-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
0.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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