Heritage Hall West - Agawam Nursing Home
General Information
UPDATEFederal Provider Number
225253
Provider Name
HERITAGE HALL WEST
Provider Address
61 COOPER ST
AGAWAM, MA 1001
AGAWAM, MA 1001
Provider Phone Number
(413) 786-8000
Provider SSA County
70
Provider County Name
Hampden
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
164
Number of Residents in Certified Beds
147
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
61 COOPER STREET OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1976-05-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.07823
Reported LPN Staffing Hours per Resident per Day
0.52993
Reported RN Staffing Hours per Resident per Day
0.97109
Reported Licensed Staffing Hours per Resident per Day
1.50102
Reported Total Nurse Staffing Hours per Resident per Day
3.57925
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10612
Expected CNA Staffing Hours per Resident per Day
2.52540
Expected LPN Staffing Hours per Resident per Day
0.68607
Expected RN Staffing Hours per Resident per Day
1.10340
Expected Total Nurse Staffing Hours per Resident per Day
4.31487
Adjusted CNA Staffing Hours per Resident per Day
2.01923
Adjusted LPN Staffing Hours per Resident per Day
0.64110
Adjusted RN Staffing Hours per Resident per Day
0.65760
Adjusted Total Nurse Staffing Hours per Resident per Day
3.34369
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-07-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-08-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
112
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-11-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
86.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
11603
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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