Worcester Rehabilitation & Health Care Center
119 Providence Street, Worcester, MA 01604


Worcester Rehabilitation & Health Care Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 225199. The address is 119 Providence Street, Worcester, MA 01604. The zip code is 01604. The phone number is 5088605000.


Worcester Rehabilitation & Health Care Center · 119 Providence Street, Worcester, MA 01604

Federal Provider Number 225199
Provider Name WORCESTER REHABILITATION & HEALTH CARE CENTER
Address 119 PROVIDENCE STREET
WORCESTER, MA 01604
Phone Number 5088605000
SSA County Code 170
County Name Worcester
Ownership Type For profit - Corporation
Certified Beds 160
Certified Beds Residents 93
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name WORCESTER MA SNF LLC
Date First Approved to Provide Medicare Medicaid Services 08/10/1970
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 Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 1
Health Inspection Rating 1
Quality Measure Rating 1
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 1.9586
Reported LPN Staffing Hours per Resident per Day 0.94892
Reported RN Staffing Hours per Resident per Day 0.7328
Reported Licensed Staffing Hours per Resident per Day 1.68172
Reported Total Nurse Staffing Hours per Resident per Day 3.64032
Reported Physical Therapist Staffing Hours per Resident Per Day 0.03602
Expected CNA Staffing Hours per Resident per Day 2.31399
Expected LPN Staffing Hours per Resident per Day 0.61199
Expected RN Staffing Hours per Resident per Day 0.95742
Expected Total Nurse Staffing Hours per Resident per Day 3.88341
Adjusted CNA Staffing Hours per Resident per Day 2.07685
Adjusted LPN Staffing Hours per Resident per Day 1.28695
Adjusted RN Staffing Hours per Resident per Day 0.5719
Adjusted Total Nurse Staffing Hours per Resident per Day 3.77858
Cycle 1 Total Number of Health Deficiencies 4
Cycle 1 Number of Standard Health Deficiencies 4
Cycle 1 Health Deficiency Score 16
Cycle 1 Standard Survey Health Date 05/25/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 16
Cycle 2 Total Number of Health Deficiencies 20
Cycle 2 Number of Standard Health Deficiencies 15
Cycle 2 Number of Complaint Health Deficiencies 5
Cycle 2 Health Deficiency Score 208
Cycle 2 Standard Health Survey Date 04/04/2016
Cycle 2 Number of Health Revisits 2
Cycle 2 Health Revisit Score 104
Cycle 2 Total Health Score 312
Cycle 3 Total Number of Health Deficiencies 10
Cycle 3 Number of Standard Health Deficiencies 10
Cycle 3 Health Deficiency Score 44
Cycle 3 Standard Health Survey Date 12/19/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 44
Total Weighted Health Survey Score 119.333
Number of Facility Reported Incidents 2
Number of Substantiated Complaints 1
Number of Fines 3
Total Amount of Fines in Dollars $104391.00
Number of Payment Denials 1
Total Number of Penalties 4
Processing Date 08/01/2017

Owner or Manager · Worcester Rehabilitation & Health Care Center

Owner Name Role Association Date
ATHENA HEALTH CARE ASSOCIATES, INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 09/01/2012
ATHENA HEALTH CARE SYSTEMS MA R LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 09/01/2012
CHAKALOS FAMILY DYNASTY TRUST F/B/O CHARLENE GALLAGHER (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2012
CHAKALOS FAMILY DYNASTY TRUST F/B/O ELAINE CHAKALOS (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2012
CHAKALOS FAMILY DYNASTY TRUST F/B/O LINDA CARMAN (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2012
CHAKALOS FAMILY DYNASTY TRUST F/B/O VALERIE SANTILLI (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2012
CHAKALOS-SANTILLI, VALERIE (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2012
CURTIS, DIANE (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2012
DOSSANTOS, LAURA (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2012
MOSIER, MICHAEL (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
6%
since 09/01/2012
MOSIER, MICHAEL (Individual) MANAGING EMPLOYEE since 09/01/2012
REZENDES, LORRIE (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 09/01/2012
SANTILLI, LAWRENCE (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
56%
since 09/01/2012
SOUCEY, DEBRA (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
6%
since 09/01/2012

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