Mineral Springs - North Conway Nursing Home
General Information
UPDATEFederal Provider Number
305084
Provider Name
MINERAL SPRINGS
Provider Address
1251 WHITE MOUNTAIN HIGHWAY
NORTH CONWAY, NH 3860
NORTH CONWAY, NH 3860
Provider Phone Number
(603) 356-7294
Provider SSA County
10
Provider County Name
Carroll
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
87
Number of Residents in Certified Beds
78
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SUNBRIDGE CLIPPER HOME OF NORTH CONWAY, INC.
Date First Approved to Provide Medicare and Medicaid services
1997-02-12
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
2.06795
Reported LPN Staffing Hours per Resident per Day
0.29231
Reported RN Staffing Hours per Resident per Day
1.07564
Reported Licensed Staffing Hours per Resident per Day
1.36795
Reported Total Nurse Staffing Hours per Resident per Day
3.43590
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06603
Expected CNA Staffing Hours per Resident per Day
2.29169
Expected LPN Staffing Hours per Resident per Day
0.60502
Expected RN Staffing Hours per Resident per Day
0.92504
Expected Total Nurse Staffing Hours per Resident per Day
3.82175
Adjusted CNA Staffing Hours per Resident per Day
2.21414
Adjusted LPN Staffing Hours per Resident per Day
0.40100
Adjusted RN Staffing Hours per Resident per Day
0.86885
Adjusted Total Nurse Staffing Hours per Resident per Day
3.62393
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-12-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
8
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
8
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-12-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
Number of Fines
2
Total Amount of Fines in Dollars
1300
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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