Stillwater Health Care - Bangor Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
205116
Provider Name
STILLWATER HEALTH CARE
Provider Address
335 STILLWATER AVE
BANGOR, ME 4401
BANGOR, ME 4401
Provider Phone Number
(207) 947-1111
Provider SSA County
90
Provider County Name
Penobscot
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
63
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHC LLC
Date First Approved to Provide Medicare and Medicaid services
1993-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
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
3.06066
Reported LPN Staffing Hours per Resident per Day
0.35492
Reported RN Staffing Hours per Resident per Day
1.00574
Reported Licensed Staffing Hours per Resident per Day
1.36066
Reported Total Nurse Staffing Hours per Resident per Day
4.42132
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14508
Expected CNA Staffing Hours per Resident per Day
2.59894
Expected LPN Staffing Hours per Resident per Day
0.70662
Expected RN Staffing Hours per Resident per Day
1.23482
Expected Total Nurse Staffing Hours per Resident per Day
4.54038
Adjusted CNA Staffing Hours per Resident per Day
2.88962
Adjusted LPN Staffing Hours per Resident per Day
0.41689
Adjusted RN Staffing Hours per Resident per Day
0.60858
Adjusted Total Nurse Staffing Hours per Resident per Day
3.92520
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
2014-07-17
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
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
2013-05-23
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
8.66700
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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