Mary's Meadow At Providence Place - Holyoke Nursing Home
General Information
UPDATEFederal Provider Number
225738
Provider Name
MARY'S MEADOW AT PROVIDENCE PLACE
Provider Address
12 GAMELIN STREET
HOLYOKE, MA 1040
HOLYOKE, MA 1040
Provider Phone Number
4134932749
Provider SSA County
70
Provider County Name
Hampden
Ownership Type
Non profit - Church related
Number of Certified Beds
40
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MARY'S MEADOW AT PROVIDENCE PLACE,INC.
Date First Approved to Provide Medicare and Medicaid services
1998-01-22
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
4.31667
Reported LPN Staffing Hours per Resident per Day
0.72308
Reported RN Staffing Hours per Resident per Day
1.52179
Reported Licensed Staffing Hours per Resident per Day
2.24487
Reported Total Nurse Staffing Hours per Resident per Day
6.56154
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11667
Expected CNA Staffing Hours per Resident per Day
2.48555
Expected LPN Staffing Hours per Resident per Day
0.56806
Expected RN Staffing Hours per Resident per Day
0.86821
Expected Total Nurse Staffing Hours per Resident per Day
3.92182
Adjusted CNA Staffing Hours per Resident per Day
4.26136
Adjusted LPN Staffing Hours per Resident per Day
1.05651
Adjusted RN Staffing Hours per Resident per Day
1.30968
Adjusted Total Nurse Staffing Hours per Resident per Day
6.74404
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-05-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2013-05-23
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
2012-06-29
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
2.00000
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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