Clipper Harbor
188 Jones Avenue, Portsmouth, NH 03801


Clipper Harbor is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 305082. The address is 188 Jones Avenue, Portsmouth, NH 03801. The zip code is 03801. The phone number is 6034312530.


Clipper Harbor · 188 Jones Avenue, Portsmouth, NH 03801

Federal Provider Number 305082
Provider Name CLIPPER HARBOR
Address 188 JONES AVENUE
PORTSMOUTH, NH 03801
Phone Number 6034312530
SSA County Code 70
County Name Rockingham
Ownership Type For profit - Corporation
Certified Beds 102
Certified Beds Residents 94
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name SUNBRIDGE CLIPPER HOME OF PORTSMOUTH, LLC
Date First Approved to Provide Medicare Medicaid Services 02/12/1997
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 2
Quality Measure Rating 2
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.07766
Reported LPN Staffing Hours per Resident per Day 0.75691
Reported RN Staffing Hours per Resident per Day 0.80319
Reported Licensed Staffing Hours per Resident per Day 1.56011
Reported Total Nurse Staffing Hours per Resident per Day 3.63776
Reported Physical Therapist Staffing Hours per Resident Per Day 0.08404
Expected CNA Staffing Hours per Resident per Day 2.40596
Expected LPN Staffing Hours per Resident per Day 0.67592
Expected RN Staffing Hours per Resident per Day 1.19698
Expected Total Nurse Staffing Hours per Resident per Day 4.27886
Adjusted CNA Staffing Hours per Resident per Day 2.11888
Adjusted LPN Staffing Hours per Resident per Day 0.92946
Adjusted RN Staffing Hours per Resident per Day 0.50138
Adjusted Total Nurse Staffing Hours per Resident per Day 3.42695
Cycle 1 Total Number of Health Deficiencies 8
Cycle 1 Number of Standard Health Deficiencies 8
Cycle 1 Health Deficiency Score 20
Cycle 1 Standard Survey Health Date 09/02/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 20
Cycle 2 Standard Health Survey Date 08/26/2015
Cycle 3 Standard Health Survey Date 06/11/2014
Total Weighted Health Survey Score 10
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Clipper Harbor

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) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
DONNA REIS 1995 FAM TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
EDWARDS, JAN (Individual) OFFICER since 12/01/2012
FC GEN OPERATIONS INVESTMENT LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
FISHMAN, STEVEN (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GEN OPERATIONS I LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GEN OPERATIONS II, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GENERAL ELECTRIC CAPITAL CORPORATION (Organization) 5% OR GREATER SECURITY INTEREST 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 12/01/2012
GENESIS HEALTHCARE LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
GENESIS HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
HCCF MANAGEMENT GROUP XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
LABATE, WENDY (Individual) OFFICER since 12/01/2012
MAYNARD, CATHERINE (Individual) MANAGING EMPLOYEE since 06/25/1999
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 12/01/2012
SHERMAN, MICHAEL (Individual) OFFICER since 12/01/2012
SUN HEALTHCARE GROUP, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SUNBRIDGE HEALTHCARE LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 01/01/1998
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 12/01/2012
ZAC PROPERTIES XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012

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