House Of The Good Shepherd - Hackettstown Nursing Home
General Information
UPDATEFederal Provider Number
315422
Provider Name
HOUSE OF THE GOOD SHEPHERD
Provider Address
798 WILLOW GROVE STREET
HACKETTSTOWN, NJ 7840
HACKETTSTOWN, NJ 7840
Provider Phone Number
(908) 684-5900
Provider SSA County
390
Provider County Name
Warren
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
62
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE HOUSE OF THE GOOD SHEPHERD
Date First Approved to Provide Medicare and Medicaid services
1997-08-25
Continuing Care Retirement Community
Y
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
5
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
2.22250
Reported LPN Staffing Hours per Resident per Day
0.65417
Reported RN Staffing Hours per Resident per Day
0.80833
Reported Licensed Staffing Hours per Resident per Day
1.46250
Reported Total Nurse Staffing Hours per Resident per Day
3.68500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15250
Expected CNA Staffing Hours per Resident per Day
2.59479
Expected LPN Staffing Hours per Resident per Day
0.59340
Expected RN Staffing Hours per Resident per Day
0.97561
Expected Total Nurse Staffing Hours per Resident per Day
4.16380
Adjusted CNA Staffing Hours per Resident per Day
2.10165
Adjusted LPN Staffing Hours per Resident per Day
0.91500
Adjusted RN Staffing Hours per Resident per Day
0.61909
Adjusted Total Nurse Staffing Hours per Resident per Day
3.56738
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
28
Cycle 1 Standard Survey Health Date
2015-04-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2014-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-04-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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