Church Home Rehabilitation And Healthcare - Fort Valley Nursing Home
General Information
UPDATEFederal Provider Number
115708
Provider Name
CHURCH HOME REHABILITATION AND HEALTHCARE
Provider Address
2470 HWY 41 N
FORT VALLEY, GA 31030
FORT VALLEY, GA 31030
Provider Phone Number
4789871239
Provider SSA County
600
Provider County Name
Houston
Ownership Type
Non profit - Church related
Number of Certified Beds
75
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHURCH HOME REHABILITATION AND HEALTHCARE, LLC
Date First Approved to Provide Medicare and Medicaid services
2005-11-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.81818
Reported LPN Staffing Hours per Resident per Day
0.90364
Reported RN Staffing Hours per Resident per Day
0.52091
Reported Licensed Staffing Hours per Resident per Day
1.42455
Reported Total Nurse Staffing Hours per Resident per Day
4.24273
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00636
Expected CNA Staffing Hours per Resident per Day
2.51974
Expected LPN Staffing Hours per Resident per Day
0.60173
Expected RN Staffing Hours per Resident per Day
0.84186
Expected Total Nurse Staffing Hours per Resident per Day
3.96333
Adjusted CNA Staffing Hours per Resident per Day
2.74432
Adjusted LPN Staffing Hours per Resident per Day
1.24643
Adjusted RN Staffing Hours per Resident per Day
0.46234
Adjusted Total Nurse Staffing Hours per Resident per Day
4.31506
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
2013-12-12
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2012-04-12
Cycle 2 Number of Health Revisits
1
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
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2010-09-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
13.33300
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
Nursiong Homes Nearby
Fort Valley Health And Rehab
604 Bluebird Boulevard |
FORT VALLEY GA 31030 | 9.9 miles away
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