Cloverdale Manor - Scottsboro Nursing Home
General Information
UPDATEFederal Provider Number
15184
Provider Name
CLOVERDALE MANOR
Provider Address
412 CLOVERDALE ROAD
SCOTTSBORO, AL 35768
SCOTTSBORO, AL 35768
Provider Phone Number
(256) 259-1505
Provider SSA County
350
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
141
Number of Residents in Certified Beds
129
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLOVERDALE HEALTH CARE, INC.
Date First Approved to Provide Medicare and Medicaid services
1977-08-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
2.73915
Reported LPN Staffing Hours per Resident per Day
0.78682
Reported RN Staffing Hours per Resident per Day
0.44767
Reported Licensed Staffing Hours per Resident per Day
1.23450
Reported Total Nurse Staffing Hours per Resident per Day
3.97364
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02829
Expected CNA Staffing Hours per Resident per Day
2.26624
Expected LPN Staffing Hours per Resident per Day
0.57005
Expected RN Staffing Hours per Resident per Day
0.76567
Expected Total Nurse Staffing Hours per Resident per Day
3.60196
Adjusted CNA Staffing Hours per Resident per Day
2.96573
Adjusted LPN Staffing Hours per Resident per Day
1.14561
Adjusted RN Staffing Hours per Resident per Day
0.43687
Adjusted Total Nurse Staffing Hours per Resident per Day
4.44684
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
2015-03-25
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
2014-04-24
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-02-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
0.66700
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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