Hawthorne House - Freeport Nursing Home
General Information
UPDATEFederal Provider Number
205098
Provider Name
HAWTHORNE HOUSE
Provider Address
6 OLD COUNTY RD
FREEPORT, ME 4032
FREEPORT, ME 4032
Provider Phone Number
(207) 865-4782
Provider SSA County
20
Provider County Name
Cumberland
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
81
Number of Residents in Certified Beds
76
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FREEPORT CONVALESCENT CENTER INC
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
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
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
3.11118
Reported LPN Staffing Hours per Resident per Day
0.55789
Reported RN Staffing Hours per Resident per Day
1.21316
Reported Licensed Staffing Hours per Resident per Day
1.77105
Reported Total Nurse Staffing Hours per Resident per Day
4.88223
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08816
Expected CNA Staffing Hours per Resident per Day
2.53030
Expected LPN Staffing Hours per Resident per Day
0.62152
Expected RN Staffing Hours per Resident per Day
0.94181
Expected Total Nurse Staffing Hours per Resident per Day
4.09362
Adjusted CNA Staffing Hours per Resident per Day
3.01700
Adjusted LPN Staffing Hours per Resident per Day
0.74503
Adjusted RN Staffing Hours per Resident per Day
0.96248
Adjusted Total Nurse Staffing Hours per Resident per Day
4.80742
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
2014-09-11
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
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-08-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-06-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
19.33300
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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