Good Shepherd Rehabilitation and Nursing Center
20 Plantation Drive, Jaffrey, NH 03452


Good Shepherd Rehabilitation and Nursing Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 305072. The address is 20 Plantation Drive, Jaffrey, NH 03452. The zip code is 03452. The phone number is 6035328762.


Good Shepherd Rehabilitation and Nursing Center · 20 Plantation Drive, Jaffrey, NH 03452

Federal Provider Number 305072
Provider Name GOOD SHEPHERD REHABILITATION AND NURSING CENTER
Address 20 PLANTATION DRIVE
JAFFREY, NH 03452
Phone Number 6035328762
SSA County Code 20
County Name Cheshire
Ownership Type Non profit - Church related
Certified Beds 83
Certified Beds Residents 54
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name GOOD SHEPHERD REHABILITATION AND NURSING CENTER
Date First Approved to Provide Medicare Medicaid Services 04/01/1996
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 5
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 3.32778
Reported LPN Staffing Hours per Resident per Day 0.77963
Reported RN Staffing Hours per Resident per Day 1.14444
Reported Licensed Staffing Hours per Resident per Day 1.92407
Reported Total Nurse Staffing Hours per Resident per Day 5.25185
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05648
Expected CNA Staffing Hours per Resident per Day 2.35418
Expected LPN Staffing Hours per Resident per Day 0.59936
Expected RN Staffing Hours per Resident per Day 0.97406
Expected Total Nurse Staffing Hours per Resident per Day 3.9276
Adjusted CNA Staffing Hours per Resident per Day 3.46846
Adjusted LPN Staffing Hours per Resident per Day 1.07964
Adjusted RN Staffing Hours per Resident per Day 0.87789
Adjusted Total Nurse Staffing Hours per Resident per Day 5.38997
Cycle 1 Total Number of Health Deficiencies 2
Cycle 1 Number of Standard Health Deficiencies 2
Cycle 1 Health Deficiency Score 8
Cycle 1 Standard Survey Health Date 08/19/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 8
Cycle 2 Total Number of Health Deficiencies 1
Cycle 2 Number of Standard Health Deficiencies 1
Cycle 2 Health Deficiency Score 8
Cycle 2 Standard Health Survey Date 08/27/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 8
Cycle 3 Total Number of Health Deficiencies 2
Cycle 3 Number of Standard Health Deficiencies 2
Cycle 3 Health Deficiency Score 8
Cycle 3 Standard Health Survey Date 09/05/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 8
Total Weighted Health Survey Score 8
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Good Shepherd Rehabilitation and Nursing Center

Owner Name Role Association Date
BLONSKI, THOMAS (Individual) DIRECTOR since 03/13/2006
BUHL, FRANK (Individual) DIRECTOR since 02/24/2003
BUNKER, RICHARD (Individual) DIRECTOR since 02/24/2003
CARNEVALE, MATTHEW (Individual) DIRECTOR since 02/24/2003
CHRISTIAN, FRANCIS (Individual) DIRECTOR since 02/24/2003
DUMAIS, JOHN (Individual) DIRECTOR since 02/24/2003
FOLEY, JOHN (Individual) DIRECTOR since 02/24/2003
GRIFFIN, CHARLES (Individual) DIRECTOR since 02/24/2003
KANEB, STEPHEN (Individual) DIRECTOR since 02/24/2003
LAMOTHE, DANIEL (Individual) DIRECTOR since 02/24/2003
MCKONE, FELICIA (Individual) DIRECTOR since 02/24/2003
MORAN, MARGARET (Individual) DIRECTOR since 02/24/2003
MORRISSETTE, RACHEL (Individual) DIRECTOR since 02/24/2003
NEW HAMPSHIRE CATHOLIC CHARITIES INC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/1990
NEW HAMPSHIRE CATHOLIC CHARITIES INC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 01/01/1990
NUNN, ANN (Individual) MANAGING EMPLOYEE since 07/08/2002
QUINN, JOHN (Individual) DIRECTOR since 02/24/2003
ST AMAND, NORMAND (Individual) DIRECTOR since 02/24/2003
SULLIVAN, PATRICIA (Individual) DIRECTOR since 02/24/2003
SULLIVAN, PATRICIA (Individual) MANAGING EMPLOYEE since 12/09/2002
VACHON, SUZANNE (Individual) DIRECTOR since 02/24/2003

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