Quaboag Rehabilitation & Skilled Care Facility - West Brookfield Nursing Home
General Information
UPDATEFederal Provider Number
225361
Provider Name
QUABOAG REHABILITATION & SKILLED CARE FACILITY
Provider Address
47 EAST MAIN STREET
WEST BROOKFIELD, MA 1585
WEST BROOKFIELD, MA 1585
Provider Phone Number
5088677716
Provider SSA County
170
Provider County Name
Worcester
Ownership Type
For profit - Partnership
Number of Certified Beds
147
Number of Residents in Certified Beds
142
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FAIR HAVENS INC
Date First Approved to Provide Medicare and Medicaid services
1989-10-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
4
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
2.24859
Reported LPN Staffing Hours per Resident per Day
0.80599
Reported RN Staffing Hours per Resident per Day
0.85810
Reported Licensed Staffing Hours per Resident per Day
1.66408
Reported Total Nurse Staffing Hours per Resident per Day
3.91268
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04190
Expected CNA Staffing Hours per Resident per Day
2.49963
Expected LPN Staffing Hours per Resident per Day
0.62762
Expected RN Staffing Hours per Resident per Day
1.01966
Expected Total Nurse Staffing Hours per Resident per Day
4.14691
Adjusted CNA Staffing Hours per Resident per Day
2.20727
Adjusted LPN Staffing Hours per Resident per Day
1.06588
Adjusted RN Staffing Hours per Resident per Day
0.62881
Adjusted Total Nurse Staffing Hours per Resident per Day
3.80322
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-07-02
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
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-06-06
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-08-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
11.33300
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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