Odd Fellows Home Of Massachusetts - Worcester Nursing Home
General Information
UPDATEFederal Provider Number
225439
Provider Name
ODD FELLOWS HOME OF MASSACHUSETTS
Provider Address
104 RANDOLPH ROAD
WORCESTER, MA 1606
WORCESTER, MA 1606
Provider Phone Number
(508) 853-6687
Provider SSA County
170
Provider County Name
Worcester
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
87
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ODD FELLOWS HOME OF MASSACHUSETTS
Date First Approved to Provide Medicare and Medicaid services
1990-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
4
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
2.43391
Reported LPN Staffing Hours per Resident per Day
0.53621
Reported RN Staffing Hours per Resident per Day
0.83046
Reported Licensed Staffing Hours per Resident per Day
1.36667
Reported Total Nurse Staffing Hours per Resident per Day
3.80058
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04080
Expected CNA Staffing Hours per Resident per Day
2.33083
Expected LPN Staffing Hours per Resident per Day
0.63841
Expected RN Staffing Hours per Resident per Day
0.94301
Expected Total Nurse Staffing Hours per Resident per Day
3.91225
Adjusted CNA Staffing Hours per Resident per Day
2.56222
Adjusted LPN Staffing Hours per Resident per Day
0.69713
Adjusted RN Staffing Hours per Resident per Day
0.65802
Adjusted Total Nurse Staffing Hours per Resident per Day
3.91585
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-12-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-12-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-07-16
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
23.33300
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
21104
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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