Pierce Mem Baptist Home - Brooklyn Nursing Home
General Information
UPDATEFederal Provider Number
75243
Provider Name
PIERCE MEM BAPTIST HOME
Provider Address
44 CANTERBURY ROAD
BROOKLYN, CT 6234
BROOKLYN, CT 6234
Provider Phone Number
8607749050
Provider SSA County
70
Provider County Name
Windham
Ownership Type
Non profit - Corporation
Number of Certified Beds
72
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PIERCE MEMORIAL BAPTIST HOME
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
2.60441
Reported LPN Staffing Hours per Resident per Day
0.81838
Reported RN Staffing Hours per Resident per Day
1.16250
Reported Licensed Staffing Hours per Resident per Day
1.98088
Reported Total Nurse Staffing Hours per Resident per Day
4.58529
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06691
Expected CNA Staffing Hours per Resident per Day
2.21923
Expected LPN Staffing Hours per Resident per Day
0.60775
Expected RN Staffing Hours per Resident per Day
0.93194
Expected Total Nurse Staffing Hours per Resident per Day
3.75892
Adjusted CNA Staffing Hours per Resident per Day
2.87958
Adjusted LPN Staffing Hours per Resident per Day
1.11766
Adjusted RN Staffing Hours per Resident per Day
0.93205
Adjusted Total Nurse Staffing Hours per Resident per Day
4.91707
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-08-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-09-20
Cycle 2 Number of Health Revisits
1
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
4
Cycle 3 Standard Health Survey Date
2012-12-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
10.66700
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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