Pleasant Valley Nursing Center - Derry Nursing Home
General Information
UPDATEFederal Provider Number
305039
Provider Name
PLEASANT VALLEY NURSING CENTER
Provider Address
8 PEABODY ROAD
DERRY, NH 3038
DERRY, NH 3038
Provider Phone Number
(603) 434-1566
Provider SSA County
70
Provider County Name
Rockingham
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
103
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PLEASANT VALLEY OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1990-02-13
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
3
Overall Rating Footnote
Health Inspection Rating
2
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
2.15922
Reported LPN Staffing Hours per Resident per Day
0.78204
Reported RN Staffing Hours per Resident per Day
0.85534
Reported Licensed Staffing Hours per Resident per Day
1.63738
Reported Total Nurse Staffing Hours per Resident per Day
3.79660
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09223
Expected CNA Staffing Hours per Resident per Day
2.34963
Expected LPN Staffing Hours per Resident per Day
0.59996
Expected RN Staffing Hours per Resident per Day
0.96813
Expected Total Nurse Staffing Hours per Resident per Day
3.91773
Adjusted CNA Staffing Hours per Resident per Day
2.25485
Adjusted LPN Staffing Hours per Resident per Day
1.08189
Adjusted RN Staffing Hours per Resident per Day
0.66015
Adjusted Total Nurse Staffing Hours per Resident per Day
3.90627
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-06-04
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
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-04-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-05-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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