Timothy Daniels House - Holliston Nursing Home

General Information

UPDATE
Federal Provider Number
225709
Provider Name
TIMOTHY DANIELS HOUSE
Provider Address
84 ELM STREET
HOLLISTON, MA 1746
Provider Phone Number
(508) 429-4566
Provider SSA County
90
Provider County Name
Middlesex
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
40
Number of Residents in Certified Beds
29
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
84 ELM ST INC.
Date First Approved to Provide Medicare and Medicaid services
1996-08-01
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
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
2.75345
Reported LPN Staffing Hours per Resident per Day
1.51034
Reported RN Staffing Hours per Resident per Day
0.96034
Reported Licensed Staffing Hours per Resident per Day
2.47069
Reported Total Nurse Staffing Hours per Resident per Day
5.22413
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16724
Expected CNA Staffing Hours per Resident per Day
2.34485
Expected LPN Staffing Hours per Resident per Day
0.63829
Expected RN Staffing Hours per Resident per Day
0.99378
Expected Total Nurse Staffing Hours per Resident per Day
3.97693
Adjusted CNA Staffing Hours per Resident per Day
2.88126
Adjusted LPN Staffing Hours per Resident per Day
1.96396
Adjusted RN Staffing Hours per Resident per Day
0.72206
Adjusted Total Nurse Staffing Hours per Resident per Day
5.29503
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
2015-03-19
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-02-04
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2013-02-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
4.00000
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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