Fair Haven Retirement Center - Birmingham Nursing Home

General Information

UPDATE
Federal Provider Number
15076
Provider Name
FAIR HAVEN RETIREMENT CENTER
Provider Address
1424 MONTCLAIR ROAD
BIRMINGHAM, AL 35210
Provider Phone Number
(205) 956-4150
Provider SSA County
360
Provider County Name
Jefferson
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
197
Number of Residents in Certified Beds
178
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
METHODIST HOME FOR THE AGING
Date First Approved to Provide Medicare and Medicaid services
1967-03-07
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
5
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
2.74944
Reported LPN Staffing Hours per Resident per Day
1.03315
Reported RN Staffing Hours per Resident per Day
0.38034
Reported Licensed Staffing Hours per Resident per Day
1.41348
Reported Total Nurse Staffing Hours per Resident per Day
4.16293
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02612
Expected CNA Staffing Hours per Resident per Day
2.33972
Expected LPN Staffing Hours per Resident per Day
0.55305
Expected RN Staffing Hours per Resident per Day
0.81233
Expected Total Nurse Staffing Hours per Resident per Day
3.70510
Adjusted CNA Staffing Hours per Resident per Day
2.88337
Adjusted LPN Staffing Hours per Resident per Day
1.55051
Adjusted RN Staffing Hours per Resident per Day
0.34985
Adjusted Total Nurse Staffing Hours per Resident per Day
4.52898
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-11-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
44.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
1755
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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