Merriman House - North Conway Nursing Home

General Information

UPDATE
Federal Provider Number
300000000000000000000000000000
Provider Name
MERRIMAN HOUSE
Provider Address
3073 WHITE MOUNTAIN HIGHWAY
NORTH CONWAY, NH 3860
Provider Phone Number
(603) 356-5461
Provider SSA County
10
Provider County Name
Carroll
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
41
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1979-02-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
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
2.69268
Reported LPN Staffing Hours per Resident per Day
0.30000
Reported RN Staffing Hours per Resident per Day
1.38780
Reported Licensed Staffing Hours per Resident per Day
1.68780
Reported Total Nurse Staffing Hours per Resident per Day
4.38048
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.57629
Expected LPN Staffing Hours per Resident per Day
0.53555
Expected RN Staffing Hours per Resident per Day
0.70610
Expected Total Nurse Staffing Hours per Resident per Day
3.81795
Adjusted CNA Staffing Hours per Resident per Day
2.56455
Adjusted LPN Staffing Hours per Resident per Day
0.46494
Adjusted RN Staffing Hours per Resident per Day
1.46857
Adjusted Total Nurse Staffing Hours per Resident per Day
4.62481
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-02
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
2013-06-26
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-05-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
0.00000
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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