Faith Haven Senior Care Centre - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
235359
Provider Name
FAITH HAVEN SENIOR CARE CENTRE
Provider Address
6531 W MICHIGAN AVENUE
JACKSON, MI 49201
JACKSON, MI 49201
Provider Phone Number
(517) 750-3822
Provider SSA County
370
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
83
Number of Residents in Certified Beds
78
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FAITH HAVEN SENIOR CARE CENTRE, LLC
Date First Approved to Provide Medicare and Medicaid services
1978-03-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.19487
Reported LPN Staffing Hours per Resident per Day
0.75192
Reported RN Staffing Hours per Resident per Day
0.58910
Reported Licensed Staffing Hours per Resident per Day
1.34103
Reported Total Nurse Staffing Hours per Resident per Day
3.53589
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04423
Expected CNA Staffing Hours per Resident per Day
2.37593
Expected LPN Staffing Hours per Resident per Day
0.67372
Expected RN Staffing Hours per Resident per Day
1.11919
Expected Total Nurse Staffing Hours per Resident per Day
4.16883
Adjusted CNA Staffing Hours per Resident per Day
2.26671
Adjusted LPN Staffing Hours per Resident per Day
0.92634
Adjusted RN Staffing Hours per Resident per Day
0.39330
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41890
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
124
Cycle 1 Standard Survey Health Date
2014-01-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
124
Cycle 2 Total Number of Health Deficiencies
22
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
120
Cycle 2 Standard Health Survey Date
2013-02-01
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
60
Cycle 2 Total Health Score
180
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
171
Cycle 3 Standard Health Survey Date
2012-03-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
171
Total Weighted Health Survey Score
150.50000
Number of Facility Reported Incidents
17
Number of Substantiated Complaints
14
Number of Fines
5
Total Amount of Fines in Dollars
63928
Number of Payment Denials
0
Total Number of Penalties
5
Location
Processing Date
2015-06-01
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