Holiday Retirement Home Inc - Manville Nursing Home
General Information
UPDATEFederal Provider Number
415075
Provider Name
HOLIDAY RETIREMENT HOME INC
Provider Address
30 SAYLES HILL ROAD
MANVILLE, RI 2838
MANVILLE, RI 2838
Provider Phone Number
4017651440
Provider SSA County
30
Provider County Name
Providence
Ownership Type
For profit - Corporation
Number of Certified Beds
170
Number of Residents in Certified Beds
154
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE HOLIDAY RETIREMENT HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1980-06-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
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
2.78669
Reported LPN Staffing Hours per Resident per Day
0.34643
Reported RN Staffing Hours per Resident per Day
0.71623
Reported Licensed Staffing Hours per Resident per Day
1.06266
Reported Total Nurse Staffing Hours per Resident per Day
3.84935
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07273
Expected CNA Staffing Hours per Resident per Day
2.51882
Expected LPN Staffing Hours per Resident per Day
0.54253
Expected RN Staffing Hours per Resident per Day
0.78331
Expected Total Nurse Staffing Hours per Resident per Day
3.84466
Adjusted CNA Staffing Hours per Resident per Day
2.71465
Adjusted LPN Staffing Hours per Resident per Day
0.52999
Adjusted RN Staffing Hours per Resident per Day
0.68321
Adjusted Total Nurse Staffing Hours per Resident per Day
4.03582
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
24
Cycle 1 Standard Survey Health Date
2015-01-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
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
2013-12-13
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-01-09
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
12.00000
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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