Carrollton Nursing & Rehab Ctr - Carrollton Nursing Home
General Information
UPDATEFederal Provider Number
115368
Provider Name
CARROLLTON NURSING & REHAB CTR
Provider Address
2327 NORTH HIGHWAY 27
CARROLLTON, GA 30117
CARROLLTON, GA 30117
Provider Phone Number
(770) 834-4404
Provider SSA County
190
Provider County Name
Carroll
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
159
Number of Residents in Certified Beds
122
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARROLLTON CYPRESS LLC
Date First Approved to Provide Medicare and Medicaid services
1989-05-04
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
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.51189
Reported LPN Staffing Hours per Resident per Day
0.96967
Reported RN Staffing Hours per Resident per Day
0.59918
Reported Licensed Staffing Hours per Resident per Day
1.56885
Reported Total Nurse Staffing Hours per Resident per Day
4.08074
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09385
Expected CNA Staffing Hours per Resident per Day
2.44472
Expected LPN Staffing Hours per Resident per Day
0.66059
Expected RN Staffing Hours per Resident per Day
1.02653
Expected Total Nurse Staffing Hours per Resident per Day
4.13185
Adjusted CNA Staffing Hours per Resident per Day
2.52112
Adjusted LPN Staffing Hours per Resident per Day
1.21834
Adjusted RN Staffing Hours per Resident per Day
0.43614
Adjusted Total Nurse Staffing Hours per Resident per Day
3.98104
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
308
Cycle 1 Standard Survey Health Date
2014-03-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
308
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2012-06-28
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2010-11-17
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
155.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
85930
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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