Cedar Valley Nsg & Rehab Ctr - Cedartown Nursing Home
General Information
UPDATEFederal Provider Number
115436
Provider Name
CEDAR VALLEY NSG & REHAB CTR
Provider Address
225 PHILPOT STREET
CEDARTOWN, GA 30125
CEDARTOWN, GA 30125
Provider Phone Number
(770) 748-4116
Provider SSA County
830
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
78
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CEDAR VALLEY CYPRESS LLC
Date First Approved to Provide Medicare and Medicaid services
1989-10-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.13333
Reported LPN Staffing Hours per Resident per Day
1.28974
Reported RN Staffing Hours per Resident per Day
0.49744
Reported Licensed Staffing Hours per Resident per Day
1.78718
Reported Total Nurse Staffing Hours per Resident per Day
3.92051
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05513
Expected CNA Staffing Hours per Resident per Day
2.56547
Expected LPN Staffing Hours per Resident per Day
0.72332
Expected RN Staffing Hours per Resident per Day
1.19713
Expected Total Nurse Staffing Hours per Resident per Day
4.48591
Adjusted CNA Staffing Hours per Resident per Day
2.04039
Adjusted LPN Staffing Hours per Resident per Day
1.47997
Adjusted RN Staffing Hours per Resident per Day
0.31048
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52285
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
16
Cycle 1 Standard Survey Health Date
2015-02-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-06-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-01-05
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
16.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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