Maine Veterans Home - Caribou - Caribou Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
205151
Provider Name
MAINE VETERANS HOME - CARIBOU
Provider Address
163 VAN BUREN RD SUITE 2
CARIBOU, ME 4736
CARIBOU, ME 4736
Provider Phone Number
(207) 498-6074
Provider SSA County
10
Provider County Name
Aroostook
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
40
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MAINE VETERANS' HOME
Date First Approved to Provide Medicare and Medicaid services
1994-07-01
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
2
Health Inspection Rating Footnote
QM Rating
5
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
3.72500
Reported LPN Staffing Hours per Resident per Day
0.15000
Reported RN Staffing Hours per Resident per Day
1.25000
Reported Licensed Staffing Hours per Resident per Day
1.40000
Reported Total Nurse Staffing Hours per Resident per Day
5.12500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06579
Expected CNA Staffing Hours per Resident per Day
2.78224
Expected LPN Staffing Hours per Resident per Day
0.58494
Expected RN Staffing Hours per Resident per Day
0.84192
Expected Total Nurse Staffing Hours per Resident per Day
4.20910
Adjusted CNA Staffing Hours per Resident per Day
3.28513
Adjusted LPN Staffing Hours per Resident per Day
0.21284
Adjusted RN Staffing Hours per Resident per Day
1.10937
Adjusted Total Nurse Staffing Hours per Resident per Day
4.90802
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-12-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-10-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-10-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
41.33300
Number of Facility Reported Incidents
1
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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