Mercy Home - Eagle Lake Nursing Home
General Information
UPDATEFederal Provider Number
205129
Provider Name
MERCY HOME
Provider Address
PO BOX 228
EAGLE LAKE, ME 4739
EAGLE LAKE, ME 4739
Provider Phone Number
2074445152
Provider SSA County
10
Provider County Name
Aroostook
Ownership Type
Non profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
36
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTHERN MAINE GENERAL
Date First Approved to Provide Medicare and Medicaid services
1993-01-01
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
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
3.24583
Reported LPN Staffing Hours per Resident per Day
0.23194
Reported RN Staffing Hours per Resident per Day
1.19028
Reported Licensed Staffing Hours per Resident per Day
1.42222
Reported Total Nurse Staffing Hours per Resident per Day
4.66805
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12639
Expected CNA Staffing Hours per Resident per Day
2.67288
Expected LPN Staffing Hours per Resident per Day
0.59900
Expected RN Staffing Hours per Resident per Day
0.90053
Expected Total Nurse Staffing Hours per Resident per Day
4.17241
Adjusted CNA Staffing Hours per Resident per Day
2.97967
Adjusted LPN Staffing Hours per Resident per Day
0.32139
Adjusted RN Staffing Hours per Resident per Day
0.98761
Adjusted Total Nurse Staffing Hours per Resident per Day
4.50973
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
12
Cycle 1 Standard Survey Health Date
2015-03-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
38.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
2800
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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