Early Memorial Nursing Home - Blakely Nursing Home
General Information
UPDATEFederal Provider Number
115271
Provider Name
EARLY MEMORIAL NURSING HOME
Provider Address
11740 COLUMBIA ROAD
BLAKELY, GA 39823
BLAKELY, GA 39823
Provider Phone Number
2297233796
Provider SSA County
410
Provider County Name
Early
Ownership Type
For profit - Corporation
Number of Certified Beds
127
Number of Residents in Certified Beds
85
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
PIONEER HEALTH SERVICES OF EARLY COUNTY, LLC
Date First Approved to Provide Medicare and Medicaid services
1979-10-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
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
1.90412
Reported LPN Staffing Hours per Resident per Day
1.12176
Reported RN Staffing Hours per Resident per Day
0.40647
Reported Licensed Staffing Hours per Resident per Day
1.52824
Reported Total Nurse Staffing Hours per Resident per Day
3.43235
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02529
Expected CNA Staffing Hours per Resident per Day
2.40634
Expected LPN Staffing Hours per Resident per Day
0.66866
Expected RN Staffing Hours per Resident per Day
0.96554
Expected Total Nurse Staffing Hours per Resident per Day
4.04054
Adjusted CNA Staffing Hours per Resident per Day
1.94160
Adjusted LPN Staffing Hours per Resident per Day
1.39243
Adjusted RN Staffing Hours per Resident per Day
0.31455
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42416
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-04-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2012-07-26
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
16
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2010-10-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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