Brandon Wilde Pavilion - Evans Nursing Home
General Information
UPDATEFederal Provider Number
115524
Provider Name
BRANDON WILDE PAVILION
Provider Address
4275 OWENS ROAD
EVANS, GA 30809
EVANS, GA 30809
Provider Phone Number
7068689800
Provider SSA County
310
Provider County Name
Columbia
Ownership Type
Non profit - Corporation
Number of Certified Beds
65
Number of Residents in Certified Beds
54
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
AUGUSTA RESOURCE CENTER ON AGING, INC.
Date First Approved to Provide Medicare and Medicaid services
1992-06-17
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
2.62407
Reported LPN Staffing Hours per Resident per Day
1.09630
Reported RN Staffing Hours per Resident per Day
0.78333
Reported Licensed Staffing Hours per Resident per Day
1.87963
Reported Total Nurse Staffing Hours per Resident per Day
4.50370
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08056
Expected CNA Staffing Hours per Resident per Day
2.62916
Expected LPN Staffing Hours per Resident per Day
0.55350
Expected RN Staffing Hours per Resident per Day
0.81188
Expected Total Nurse Staffing Hours per Resident per Day
3.99454
Adjusted CNA Staffing Hours per Resident per Day
2.44895
Adjusted LPN Staffing Hours per Resident per Day
1.64395
Adjusted RN Staffing Hours per Resident per Day
0.72093
Adjusted Total Nurse Staffing Hours per Resident per Day
4.54470
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-05-08
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2011-12-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
1.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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
Nursiong Homes Nearby
University Extended Care/westw
561 University Drive |
EVANS GA 30809 | 0.3 mile away
Lake Crossing Health Center
6698 Washington Road |
APPLING GA 30802 | 15.9 miles away
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