Adams Farm Living & Rehabilitation - Jamestown Nursing Home
General Information
UPDATEFederal Provider Number
345535
Provider Name
ADAMS FARM LIVING & REHABILITATION
Provider Address
5100 MACKAY ROAD
JAMESTOWN, NC 27282
JAMESTOWN, NC 27282
Provider Phone Number
(336) 855-5596
Provider SSA County
400
Provider County Name
Guilford
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
90
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ADAMS FARM LIVING INC
Date First Approved to Provide Medicare and Medicaid services
2005-11-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.06944
Reported LPN Staffing Hours per Resident per Day
0.74778
Reported RN Staffing Hours per Resident per Day
0.63611
Reported Licensed Staffing Hours per Resident per Day
1.38389
Reported Total Nurse Staffing Hours per Resident per Day
3.45333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04389
Expected CNA Staffing Hours per Resident per Day
2.51555
Expected LPN Staffing Hours per Resident per Day
0.69313
Expected RN Staffing Hours per Resident per Day
1.20168
Expected Total Nurse Staffing Hours per Resident per Day
4.41036
Adjusted CNA Staffing Hours per Resident per Day
2.01856
Adjusted LPN Staffing Hours per Resident per Day
0.89544
Adjusted RN Staffing Hours per Resident per Day
0.39553
Adjusted Total Nurse Staffing Hours per Resident per Day
3.15621
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-07-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-04-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-05-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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