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Douglasville Nursing And Rehabilitation Center - Douglasville Nursing Home

General Information

UPDATE
Federal Provider Number
115273
Provider Name
DOUGLASVILLE NURSING AND REHABILITATION CENTER
Provider Address
4028 HWY 5
DOUGLASVILLE, GA 30135
Provider Phone Number
7709427111
Provider SSA County
400
Provider County Name
Douglas
Ownership Type
For profit - Partnership
Number of Certified Beds
246
Number of Residents in Certified Beds
231
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DOUGLASVILLE NURSING AND REHABILITATION CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1980-02-01
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
4
Health Inspection Rating Footnote
QM Rating
1
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
2.26905
Reported LPN Staffing Hours per Resident per Day
1.17619
Reported RN Staffing Hours per Resident per Day
0.47121
Reported Licensed Staffing Hours per Resident per Day
1.64740
Reported Total Nurse Staffing Hours per Resident per Day
3.91645
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06797
Expected CNA Staffing Hours per Resident per Day
2.49370
Expected LPN Staffing Hours per Resident per Day
0.74095
Expected RN Staffing Hours per Resident per Day
1.20139
Expected Total Nurse Staffing Hours per Resident per Day
4.43603
Adjusted CNA Staffing Hours per Resident per Day
2.23265
Adjusted LPN Staffing Hours per Resident per Day
1.31756
Adjusted RN Staffing Hours per Resident per Day
0.29307
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55877
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2012-11-29
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
4
Cycle 3 Standard Health Survey Date
2011-06-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
8.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
7898
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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