Mt Greylock Extended Care Facility - Pittsfield Nursing Home
General Information
UPDATEFederal Provider Number
225306
Provider Name
MT GREYLOCK EXTENDED CARE FACILITY
Provider Address
1000 NORTH STREET
PITTSFIELD, MA 1201
PITTSFIELD, MA 1201
Provider Phone Number
(413) 499-7186
Provider SSA County
10
Provider County Name
Berkshire
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
99
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PITTSFIELD MANAGEMENT SYSTEMS INC.
Date First Approved to Provide Medicare and Medicaid services
1987-12-02
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.39646
Reported LPN Staffing Hours per Resident per Day
0.98990
Reported RN Staffing Hours per Resident per Day
0.79545
Reported Licensed Staffing Hours per Resident per Day
1.78535
Reported Total Nurse Staffing Hours per Resident per Day
4.18181
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15354
Expected CNA Staffing Hours per Resident per Day
2.37221
Expected LPN Staffing Hours per Resident per Day
0.63223
Expected RN Staffing Hours per Resident per Day
1.05852
Expected Total Nurse Staffing Hours per Resident per Day
4.06296
Adjusted CNA Staffing Hours per Resident per Day
2.47879
Adjusted LPN Staffing Hours per Resident per Day
1.29955
Adjusted RN Staffing Hours per Resident per Day
0.56150
Adjusted Total Nurse Staffing Hours per Resident per Day
4.14881
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-04-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-06-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-05-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
13.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
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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