Hattie Ide Chaffee Home - East Providence Nursing Home

General Information

UPDATE
Federal Provider Number
415002
Provider Name
HATTIE IDE CHAFFEE HOME
Provider Address
200 WAMPANOAG TRAIL
EAST PROVIDENCE, RI 2914
Provider Phone Number
(401) 434-1520
Provider SSA County
30
Provider County Name
Providence
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HATTIE IDE CHAFFEE NURSING HOME INC
Date First Approved to Provide Medicare and Medicaid services
1981-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
3.07632
Reported LPN Staffing Hours per Resident per Day
0.15702
Reported RN Staffing Hours per Resident per Day
0.99211
Reported Licensed Staffing Hours per Resident per Day
1.14912
Reported Total Nurse Staffing Hours per Resident per Day
4.22545
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08421
Expected CNA Staffing Hours per Resident per Day
2.58506
Expected LPN Staffing Hours per Resident per Day
0.62299
Expected RN Staffing Hours per Resident per Day
1.09557
Expected Total Nurse Staffing Hours per Resident per Day
4.30363
Adjusted CNA Staffing Hours per Resident per Day
2.92000
Adjusted LPN Staffing Hours per Resident per Day
0.20919
Adjusted RN Staffing Hours per Resident per Day
0.67664
Adjusted Total Nurse Staffing Hours per Resident per Day
3.95768
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
0
Cycle 1 Standard Survey Health Date
2015-02-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
16
Cycle 2 Standard Health Survey Date
2014-03-26
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
20
Cycle 3 Standard Health Survey Date
2013-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
8.66700
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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