Commonwealth Health & Rehab Center - Fairfax Nursing Home
General Information
UPDATEFederal Provider Number
495174
Provider Name
COMMONWEALTH HEALTH & REHAB CENTER
Provider Address
4315 CHAIN BRIDGE ROAD
FAIRFAX, VA 22030
FAIRFAX, VA 22030
Provider Phone Number
(703) 934-5000
Provider SSA County
288
Provider County Name
Fairfax City
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
37
Number of Residents in Certified Beds
130
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CSP NOVA LLC
Date First Approved to Provide Medicare and Medicaid services
1987-12-09
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.30538
Reported LPN Staffing Hours per Resident per Day
1.29885
Reported RN Staffing Hours per Resident per Day
0.81269
Reported Licensed Staffing Hours per Resident per Day
2.11154
Reported Total Nurse Staffing Hours per Resident per Day
4.41692
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12654
Expected CNA Staffing Hours per Resident per Day
2.64579
Expected LPN Staffing Hours per Resident per Day
0.69587
Expected RN Staffing Hours per Resident per Day
1.10674
Expected Total Nurse Staffing Hours per Resident per Day
4.44841
Adjusted CNA Staffing Hours per Resident per Day
2.13800
Adjusted LPN Staffing Hours per Resident per Day
1.54920
Adjusted RN Staffing Hours per Resident per Day
0.54867
Adjusted Total Nurse Staffing Hours per Resident per Day
4.00237
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
11
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
36
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
13
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-04-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
92.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
22
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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Nursiong Homes Nearby
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