Coastal Manor - Ludowici Nursing Home
General Information
UPDATEFederal Provider Number
115665
Provider Name
COASTAL MANOR
Provider Address
128 COASTAL MANOR DRIVE SE
LUDOWICI, GA 31316
LUDOWICI, GA 31316
Provider Phone Number
9125453392
Provider SSA County
691
Provider County Name
Long
Ownership Type
Government - County
Number of Certified Beds
108
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
HOSPTIAL AUTHORITY OF LIBERTY COUNTY
Date First Approved to Provide Medicare and Medicaid services
2000-01-14
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.73333
Reported LPN Staffing Hours per Resident per Day
1.32157
Reported RN Staffing Hours per Resident per Day
0.33775
Reported Licensed Staffing Hours per Resident per Day
1.65931
Reported Total Nurse Staffing Hours per Resident per Day
4.39265
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04216
Expected CNA Staffing Hours per Resident per Day
2.56182
Expected LPN Staffing Hours per Resident per Day
0.64956
Expected RN Staffing Hours per Resident per Day
0.89253
Expected Total Nurse Staffing Hours per Resident per Day
4.10392
Adjusted CNA Staffing Hours per Resident per Day
2.61797
Adjusted LPN Staffing Hours per Resident per Day
1.68868
Adjusted RN Staffing Hours per Resident per Day
0.28275
Adjusted Total Nurse Staffing Hours per Resident per Day
4.31450
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2013-02-07
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-09-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
6.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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