Sudbury Pines Extended Care - Sudbury Nursing Home
General Information
UPDATEFederal Provider Number
225531
Provider Name
SUDBURY PINES EXTENDED CARE
Provider Address
642 BOSTON POST ROAD
SUDBURY, MA 1776
SUDBURY, MA 1776
Provider Phone Number
9784439000
Provider SSA County
90
Provider County Name
Middlesex
Ownership Type
For profit - Corporation
Number of Certified Beds
92
Number of Residents in Certified Beds
78
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SUDBURY PINES EXTENDED CARE FACILITY
Date First Approved to Provide Medicare and Medicaid services
1991-01-08
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.66859
Reported LPN Staffing Hours per Resident per Day
0.94487
Reported RN Staffing Hours per Resident per Day
0.59487
Reported Licensed Staffing Hours per Resident per Day
1.53974
Reported Total Nurse Staffing Hours per Resident per Day
4.20833
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08718
Expected CNA Staffing Hours per Resident per Day
2.45502
Expected LPN Staffing Hours per Resident per Day
0.66283
Expected RN Staffing Hours per Resident per Day
1.00072
Expected Total Nurse Staffing Hours per Resident per Day
4.11857
Adjusted CNA Staffing Hours per Resident per Day
2.66715
Adjusted LPN Staffing Hours per Resident per Day
1.18318
Adjusted RN Staffing Hours per Resident per Day
0.44417
Adjusted Total Nurse Staffing Hours per Resident per Day
4.11875
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2015-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-01-09
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-11-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
48.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
1625
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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