Nim Henson Geriatric Center - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
185112
Provider Name
NIM HENSON GERIATRIC CENTER
Provider Address
420 JETT DRIVE
JACKSON, KY 41339
JACKSON, KY 41339
Provider Phone Number
6066662456
Provider SSA County
120
Provider County Name
Breathitt
Ownership Type
Non profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
76
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BREATITT COUNTY GERIATRIC CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1972-07-19
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.14342
Reported LPN Staffing Hours per Resident per Day
0.78750
Reported RN Staffing Hours per Resident per Day
1.02434
Reported Licensed Staffing Hours per Resident per Day
1.81184
Reported Total Nurse Staffing Hours per Resident per Day
3.95526
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05987
Expected CNA Staffing Hours per Resident per Day
2.29298
Expected LPN Staffing Hours per Resident per Day
0.64772
Expected RN Staffing Hours per Resident per Day
0.96366
Expected Total Nurse Staffing Hours per Resident per Day
3.90436
Adjusted CNA Staffing Hours per Resident per Day
2.29366
Adjusted LPN Staffing Hours per Resident per Day
1.00911
Adjusted RN Staffing Hours per Resident per Day
0.79425
Adjusted Total Nurse Staffing Hours per Resident per Day
4.08345
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-02-06
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-02-14
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
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-01-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
50.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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