Fairfax Nursing Center Inc - Fairfax Nursing Home
General Information
UPDATEFederal Provider Number
495099
Provider Name
FAIRFAX NURSING CENTER INC
Provider Address
10701 MAIN STREET
FAIRFAX, VA 22030
FAIRFAX, VA 22030
Provider Phone Number
(703) 273-7705
Provider SSA County
288
Provider County Name
Fairfax City
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
200
Number of Residents in Certified Beds
190
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1976-04-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.33816
Reported LPN Staffing Hours per Resident per Day
1.35342
Reported RN Staffing Hours per Resident per Day
0.98053
Reported Licensed Staffing Hours per Resident per Day
2.33395
Reported Total Nurse Staffing Hours per Resident per Day
5.67211
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11289
Expected CNA Staffing Hours per Resident per Day
2.68736
Expected LPN Staffing Hours per Resident per Day
0.63998
Expected RN Staffing Hours per Resident per Day
1.02344
Expected Total Nurse Staffing Hours per Resident per Day
4.35078
Adjusted CNA Staffing Hours per Resident per Day
3.04791
Adjusted LPN Staffing Hours per Resident per Day
1.75527
Adjusted RN Staffing Hours per Resident per Day
0.71587
Adjusted Total Nurse Staffing Hours per Resident per Day
5.25509
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-06-28
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-07-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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