Mountain Manor Of Paintsville - Paintsville Nursing Home
General Information
UPDATEFederal Provider Number
185414
Provider Name
MOUNTAIN MANOR OF PAINTSVILLE
Provider Address
1025 EUCLID AVENUE
PAINTSVILLE, KY 41240
PAINTSVILLE, KY 41240
Provider Phone Number
6067895808
Provider SSA County
570
Provider County Name
Johnson
Ownership Type
For profit - Corporation
Number of Certified Beds
126
Number of Residents in Certified Beds
121
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PAINTSVILLE INVESTORS, LLC
Date First Approved to Provide Medicare and Medicaid services
1995-09-19
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.80992
Reported LPN Staffing Hours per Resident per Day
0.98264
Reported RN Staffing Hours per Resident per Day
0.62645
Reported Licensed Staffing Hours per Resident per Day
1.60909
Reported Total Nurse Staffing Hours per Resident per Day
4.41901
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04545
Expected CNA Staffing Hours per Resident per Day
2.80040
Expected LPN Staffing Hours per Resident per Day
0.78887
Expected RN Staffing Hours per Resident per Day
1.14406
Expected Total Nurse Staffing Hours per Resident per Day
4.73334
Adjusted CNA Staffing Hours per Resident per Day
2.46204
Adjusted LPN Staffing Hours per Resident per Day
1.03387
Adjusted RN Staffing Hours per Resident per Day
0.40914
Adjusted Total Nurse Staffing Hours per Resident per Day
3.76322
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-02-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
17
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
13
Cycle 3 Health Deficiency Score
465
Cycle 3 Standard Health Survey Date
2012-12-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
465
Total Weighted Health Survey Score
89.50000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
Number of Fines
2
Total Amount of Fines in Dollars
53900
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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