Extendicare Health Center - Dothan Nursing Home
General Information
UPDATEFederal Provider Number
15152
Provider Name
EXTENDICARE HEALTH CENTER
Provider Address
950 SOUTH ST. ANDREWS STREET
DOTHAN, AL 36302
DOTHAN, AL 36302
Provider Phone Number
(334) 793-1177
Provider SSA County
340
Provider County Name
Houston
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
170
Number of Residents in Certified Beds
164
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EXTENDICARE, INC
Date First Approved to Provide Medicare and Medicaid services
1978-04-18
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
3
Health Inspection Rating Footnote
QM Rating
5
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
3.05793
Reported LPN Staffing Hours per Resident per Day
1.25305
Reported RN Staffing Hours per Resident per Day
0.80274
Reported Licensed Staffing Hours per Resident per Day
2.05579
Reported Total Nurse Staffing Hours per Resident per Day
5.11372
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08018
Expected CNA Staffing Hours per Resident per Day
2.51547
Expected LPN Staffing Hours per Resident per Day
0.64546
Expected RN Staffing Hours per Resident per Day
0.99514
Expected Total Nurse Staffing Hours per Resident per Day
4.15607
Adjusted CNA Staffing Hours per Resident per Day
2.98283
Adjusted LPN Staffing Hours per Resident per Day
1.61130
Adjusted RN Staffing Hours per Resident per Day
0.60274
Adjusted Total Nurse Staffing Hours per Resident per Day
4.95971
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
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
28
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
16
Cycle 2 Standard Health Survey Date
2013-08-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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