Autumn Breeze Health Care Ctr - Marietta Nursing Home
General Information
UPDATEFederal Provider Number
115580
Provider Name
AUTUMN BREEZE HEALTH CARE CTR
Provider Address
1480 SANDTOWN ROAD
MARIETTA, GA 30008
MARIETTA, GA 30008
Provider Phone Number
(770) 422-1755
Provider SSA County
290
Provider County Name
Cobb
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
109
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MT. KENN NURSING, LLC
Date First Approved to Provide Medicare and Medicaid services
1995-03-01
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
2
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.66522
Reported LPN Staffing Hours per Resident per Day
0.94565
Reported RN Staffing Hours per Resident per Day
0.48533
Reported Licensed Staffing Hours per Resident per Day
1.43098
Reported Total Nurse Staffing Hours per Resident per Day
3.09620
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05978
Expected CNA Staffing Hours per Resident per Day
2.25924
Expected LPN Staffing Hours per Resident per Day
0.58400
Expected RN Staffing Hours per Resident per Day
1.03408
Expected Total Nurse Staffing Hours per Resident per Day
3.87732
Adjusted CNA Staffing Hours per Resident per Day
1.80855
Adjusted LPN Staffing Hours per Resident per Day
1.34400
Adjusted RN Staffing Hours per Resident per Day
0.35069
Adjusted Total Nurse Staffing Hours per Resident per Day
3.21884
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-10-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-01-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2011-07-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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