Care One At Jackson - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
315240
Provider Name
CARE ONE AT JACKSON
Provider Address
11 HISTORY LANE
JACKSON, NJ 8527
JACKSON, NJ 8527
Provider Phone Number
(732) 367-6600
Provider SSA County
310
Provider County Name
Ocean
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
186
Number of Residents in Certified Beds
127
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
11 HISTORY LANE OPERATING COMPANY, LLC
Date First Approved to Provide Medicare and Medicaid services
1986-10-31
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
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.35433
Reported LPN Staffing Hours per Resident per Day
1.09488
Reported RN Staffing Hours per Resident per Day
0.79606
Reported Licensed Staffing Hours per Resident per Day
1.89094
Reported Total Nurse Staffing Hours per Resident per Day
4.24527
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07717
Expected CNA Staffing Hours per Resident per Day
2.57020
Expected LPN Staffing Hours per Resident per Day
0.65581
Expected RN Staffing Hours per Resident per Day
1.09289
Expected Total Nurse Staffing Hours per Resident per Day
4.31890
Adjusted CNA Staffing Hours per Resident per Day
2.24761
Adjusted LPN Staffing Hours per Resident per Day
1.38570
Adjusted RN Staffing Hours per Resident per Day
0.54426
Adjusted Total Nurse Staffing Hours per Resident per Day
3.96218
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-02-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-04-02
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
20
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
19
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
275
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
275
Total Weighted Health Survey Score
71.83300
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
8
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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