Kindred Transitional Care & Rehab-country Estates - Agawam Nursing Home
General Information
UPDATEFederal Provider Number
225642
Provider Name
KINDRED TRANSITIONAL CARE & REHAB-COUNTRY ESTATES
Provider Address
1200 SUFFIELD STREET
AGAWAM, MA 1001
AGAWAM, MA 1001
Provider Phone Number
(413) 789-2200
Provider SSA County
70
Provider County Name
Hampden
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
176
Number of Residents in Certified Beds
158
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRY ESTATES NURSING, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
1994-07-26
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
1
QM Rating Footnote
Staffing Rating
3
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
1.91456
Reported LPN Staffing Hours per Resident per Day
0.77184
Reported RN Staffing Hours per Resident per Day
1.06930
Reported Licensed Staffing Hours per Resident per Day
1.84114
Reported Total Nurse Staffing Hours per Resident per Day
3.75570
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08228
Expected CNA Staffing Hours per Resident per Day
2.43709
Expected LPN Staffing Hours per Resident per Day
0.65143
Expected RN Staffing Hours per Resident per Day
1.07532
Expected Total Nurse Staffing Hours per Resident per Day
4.16384
Adjusted CNA Staffing Hours per Resident per Day
1.92761
Adjusted LPN Staffing Hours per Resident per Day
0.98342
Adjusted RN Staffing Hours per Resident per Day
0.74302
Adjusted Total Nurse Staffing Hours per Resident per Day
3.63579
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-10-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-10-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
100
Cycle 3 Standard Health Survey Date
2012-10-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
100
Total Weighted Health Survey Score
59.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
4
Total Amount of Fines in Dollars
60675
Number of Payment Denials
0
Total Number of Penalties
4
Location
Processing Date
2015-06-01
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