Pawtucket Skilled Nursing & Rehabilitation - Pawtucket Nursing Home
General Information
UPDATEFederal Provider Number
415064
Provider Name
PAWTUCKET SKILLED NURSING & REHABILITATION
Provider Address
70 GILL AVENUE
PAWTUCKET, RI 2861
PAWTUCKET, RI 2861
Provider Phone Number
(401) 722-7900
Provider SSA County
30
Provider County Name
Providence
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
154
Number of Residents in Certified Beds
146
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
70 GILL AVENUE OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1979-12-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.69623
Reported LPN Staffing Hours per Resident per Day
0.45582
Reported RN Staffing Hours per Resident per Day
0.69315
Reported Licensed Staffing Hours per Resident per Day
1.14897
Reported Total Nurse Staffing Hours per Resident per Day
3.84520
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08870
Expected CNA Staffing Hours per Resident per Day
2.32072
Expected LPN Staffing Hours per Resident per Day
0.63636
Expected RN Staffing Hours per Resident per Day
1.09886
Expected Total Nurse Staffing Hours per Resident per Day
4.05594
Adjusted CNA Staffing Hours per Resident per Day
2.85072
Adjusted LPN Staffing Hours per Resident per Day
0.59452
Adjusted RN Staffing Hours per Resident per Day
0.47133
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82146
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
2014-11-19
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-10-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
19
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2012-10-12
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
48
Cycle 3 Total Health Score
144
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
5
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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