Apple Valley Center
400 Groton Road, Ayer, MA 01432


Apple Valley Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 225421. The address is 400 Groton Road, Ayer, MA 01432. The zip code is 01432. The phone number is 9787721704.


Apple Valley Center · 400 Groton Road, Ayer, MA 01432

Federal Provider Number 225421
Provider Name APPLE VALLEY CENTER
Address 400 GROTON ROAD
AYER, MA 01432
Phone Number 9787721704
SSA County Code 90
County Name Middlesex
Ownership Type For profit - Corporation
Certified Beds 123
Certified Beds Residents 107
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name 400 GROTON ROAD OPERATIONS LLC
Date First Approved to Provide Medicare Medicaid Services 07/01/1990
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 2
Health Inspection Rating 1
Quality Measure Rating 5
Staffing Rating 3
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 1.61215
Reported LPN Staffing Hours per Resident per Day 0.94673
Reported RN Staffing Hours per Resident per Day 0.87897
Reported Licensed Staffing Hours per Resident per Day 1.8257
Reported Total Nurse Staffing Hours per Resident per Day 3.43785
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05327
Expected CNA Staffing Hours per Resident per Day 2.66662
Expected LPN Staffing Hours per Resident per Day 0.58949
Expected RN Staffing Hours per Resident per Day 0.89376
Expected Total Nurse Staffing Hours per Resident per Day 4.14987
Adjusted CNA Staffing Hours per Resident per Day 1.48343
Adjusted LPN Staffing Hours per Resident per Day 1.33299
Adjusted RN Staffing Hours per Resident per Day 0.73484
Adjusted Total Nurse Staffing Hours per Resident per Day 3.33929
Cycle 1 Total Number of Health Deficiencies 10
Cycle 1 Number of Standard Health Deficiencies 6
Cycle 1 Number of Complaint Health Deficiencies 4
Cycle 1 Health Deficiency Score 72
Cycle 1 Standard Survey Health Date 04/19/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 72
Cycle 2 Total Number of Health Deficiencies 7
Cycle 2 Number of Standard Health Deficiencies 7
Cycle 2 Health Deficiency Score 48
Cycle 2 Standard Health Survey Date 03/08/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 48
Cycle 3 Total Number of Health Deficiencies 1
Cycle 3 Number of Standard Health Deficiencies 1
Cycle 3 Health Deficiency Score 16
Cycle 3 Standard Health Survey Date 12/01/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 16
Total Weighted Health Survey Score 54.667
Number of Facility Reported Incidents 1
Number of Fines 1
Total Amount of Fines in Dollars $29432.00
Total Number of Penalties 1
Processing Date 08/01/2017

Owner or Manager · Apple Valley Center

Owner Name Role Association Date
BERG, MICHAEL (Individual) OFFICER since 12/01/2012
BERG, MICHAEL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
CULLEROT, KENNETH (Individual) OFFICER since 03/02/2015
DAVIS, KEITH (Individual) MANAGING EMPLOYEE since 04/01/2011
DAVIS, KEITH (Individual) OPERATIONAL/MANAGERIAL CONTROL since 03/02/2015
DONNA REIS 1995 FAM TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
EDWARDS, JAN (Individual) OFFICER since 03/02/2015
FC-GEN OPERATIONS INVESTMENT LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
FISHMAN, STEVEN (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
FISHMAN, STEVEN (Individual) DIRECTOR since 12/31/2011
FISHMAN, STEVEN (Individual) OFFICER since 12/31/2011
GEN OPERATIONS I LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GEN OPERATIONS II, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GENESIS HEALTHCARE INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GENESIS HEALTHCARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GENESIS HEALTHCARE LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 04/01/2011
GENESIS HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GENESIS MA HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
GENESIS OPERATIONS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
GHC HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011
GREEN, MIATTA (Individual) MANAGING EMPLOYEE since 03/03/2015
HCCF MANAGEMENT GROUP XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
LABATE, WENDY (Individual) OFFICER since 02/02/2015
LABATE, WENDY (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
ONEX PARTNERS LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SENIOR CARE GENESIS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SENIOR CARE HOLDINGS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SHERMAN, MICHAEL (Individual) DIRECTOR since 04/01/2011
SHERMAN, MICHAEL (Individual) OFFICER since 03/02/2015
SUN HEALTHCARE GROUP, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SUNDANCE REHABILITATION HOLDCO, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2016
WHITMAN, ARNOLD (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011
WHITMAN, ARNOLD (Individual) DIRECTOR since 12/31/2011
WHITMAN, ARNOLD (Individual) OFFICER since 12/31/2011
ZAC PROPERTIES XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2011

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