Hermitage Rehabilitation Center (the)
383 Mill Street, Worcester, MA 01602


Hermitage Rehabilitation Center (the) is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 225009. The address is 383 Mill Street, Worcester, MA 01602. The zip code is 01602. The phone number is 5087918131.


Hermitage Rehabilitation Center (the) · 383 Mill Street, Worcester, MA 01602

Federal Provider Number 225009
Provider Name HERMITAGE REHABILITATION CENTER (THE)
Address 383 MILL STREET
WORCESTER, MA 01602
Phone Number 5087918131
SSA County Code 170
County Name Worcester
Ownership Type For profit - Corporation
Certified Beds 101
Certified Beds Residents 95
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name GGNSC WORCESTER LLC
Date First Approved to Provide Medicare Medicaid Services 01/01/1967
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 2
Quality Measure Rating 2
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.19421
Reported LPN Staffing Hours per Resident per Day 0.72053
Reported RN Staffing Hours per Resident per Day 0.50316
Reported Licensed Staffing Hours per Resident per Day 1.22368
Reported Total Nurse Staffing Hours per Resident per Day 3.4179
Reported Physical Therapist Staffing Hours per Resident Per Day 0.03316
Expected CNA Staffing Hours per Resident per Day 2.51569
Expected LPN Staffing Hours per Resident per Day 0.55197
Expected RN Staffing Hours per Resident per Day 0.80795
Expected Total Nurse Staffing Hours per Resident per Day 3.87561
Adjusted CNA Staffing Hours per Resident per Day 2.14014
Adjusted LPN Staffing Hours per Resident per Day 1.08347
Adjusted RN Staffing Hours per Resident per Day 0.46533
Adjusted Total Nurse Staffing Hours per Resident per Day 3.55485
Cycle 1 Total Number of Health Deficiencies 9
Cycle 1 Number of Standard Health Deficiencies 8
Cycle 1 Number of Complaint Health Deficiencies 1
Cycle 1 Health Deficiency Score 48
Cycle 1 Standard Survey Health Date 09/16/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 48
Cycle 2 Total Number of Health Deficiencies 4
Cycle 2 Number of Standard Health Deficiencies 4
Cycle 2 Health Deficiency Score 40
Cycle 2 Standard Health Survey Date 06/12/2015
Cycle 2 Number of Health Revisits 2
Cycle 2 Health Revisit Score 20
Cycle 2 Total Health Score 60
Cycle 3 Total Number of Health Deficiencies 8
Cycle 3 Number of Standard Health Deficiencies 8
Cycle 3 Health Deficiency Score 40
Cycle 3 Standard Health Survey Date 06/10/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 40
Total Weighted Health Survey Score 50.667
Number of Facility Reported Incidents 1
Number of Substantiated Complaints 3
Number of Fines 1
Total Amount of Fines in Dollars $20703.00
Total Number of Penalties 1
Processing Date 08/01/2017

Owner or Manager · Hermitage Rehabilitation Center (the)

Owner Name Role Association Date
CHAVIS, TINA (Individual) OFFICER since 08/15/2006
DRUMM MERGER CO (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
DRUMM MERGER CO (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
FILLMORE CAPITAL PARTNERS, LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 03/15/2006
FILLMORE STRATEGIC INVESTORS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
FILLMORE STRATEGIC INVESTORS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
FILLMORE STRATEGIC MANAGEMENT, LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 03/15/2006
FINN, NICHOLAS (Individual) OFFICER since 11/03/2009
GGNSC EQUITY HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 03/15/2006
GGNSC HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
GGNSC HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
GOLDEN GATE NATIONAL SENIOR CARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
HELM, PAUL (Individual) OFFICER since 01/02/2012
JASINSKI, DAVID (Individual) MANAGING EMPLOYEE since 02/09/2014
JOSEPH, LARRY (Individual) OFFICER since 08/15/2006
KARICHER, MICHAEL (Individual) OFFICER since 01/02/2012
RASMUSSEN-JONES, HOLLY (Individual) OFFICER since 08/15/2006
ROGERS, STACEY (Individual) OFFICER since 04/19/2012
SALAMONE, SALVATORE (Individual) OFFICER since 01/15/2007
SWARTZ, GREGORY (Individual) OFFICER since 08/15/2006
TRUITT, ANN (Individual) OFFICER since 08/15/2006
VARDELL, KATHLEEN (Individual) DIRECTOR since 08/01/2012
VARDELL, KATHLEEN (Individual) OFFICER since 08/01/2012
WASHINGTON STATE INVESTMENT BOARD (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
WASHINGTON STATE INVESTMENT BOARD (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
WILLIAMS, ROBERTA (Individual) OFFICER since 08/15/2006

street_number: 383
route: Mill Street (Mill St)
neighborhood, political: Webster Square
locality, political: Worcester
admin_level_2, political: Worcester County
admin_level_1, political: Massachusetts (MA)
country, political: United States (US)
postal_code: 01602
postal_code_suffix: 2414
types : street_address
latitude: 42.2614884
longitude: -71.8507069
latlng: (42.2614884, -71.8507069)


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