St Joseph Residence - Manchester Nursing Home
General Information
UPDATEFederal Provider Number
305088
Provider Name
ST JOSEPH RESIDENCE
Provider Address
495 MAMMOTH RD
MANCHESTER, NH 3104
MANCHESTER, NH 3104
Provider Phone Number
(603) 668-6011
Provider SSA County
50
Provider County Name
Hillsborough
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
22
Number of Residents in Certified Beds
21
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SAINT JOSEPH RESIDENCE
Date First Approved to Provide Medicare and Medicaid services
1997-07-02
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
3.23571
Reported LPN Staffing Hours per Resident per Day
0.42143
Reported RN Staffing Hours per Resident per Day
1.42857
Reported Licensed Staffing Hours per Resident per Day
1.85000
Reported Total Nurse Staffing Hours per Resident per Day
5.08571
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.33427
Expected LPN Staffing Hours per Resident per Day
0.59919
Expected RN Staffing Hours per Resident per Day
0.99597
Expected Total Nurse Staffing Hours per Resident per Day
3.92943
Adjusted CNA Staffing Hours per Resident per Day
3.40127
Adjusted LPN Staffing Hours per Resident per Day
0.58376
Adjusted RN Staffing Hours per Resident per Day
1.07174
Adjusted Total Nurse Staffing Hours per Resident per Day
5.21703
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
2014-06-25
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
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
8
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
4
Cycle 3 Standard Health Survey Date
2012-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
3.33300
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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