Forest Cove Nursing And Rehab Center - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
445453
Provider Name
FOREST COVE NURSING AND REHAB CENTER
Provider Address
45 FOREST COVE
JACKSON, TN 38301
JACKSON, TN 38301
Provider Phone Number
(731) 424-4200
Provider SSA County
560
Provider County Name
Madison
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
170
Number of Residents in Certified Beds
116
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOREST COVE NURSING AND REHAB CENTER INC
Date First Approved to Provide Medicare and Medicaid services
2002-07-01
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
4
Health Inspection Rating Footnote
QM Rating
2
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
2.41466
Reported LPN Staffing Hours per Resident per Day
1.21379
Reported RN Staffing Hours per Resident per Day
0.62328
Reported Licensed Staffing Hours per Resident per Day
1.83707
Reported Total Nurse Staffing Hours per Resident per Day
4.25173
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04009
Expected CNA Staffing Hours per Resident per Day
2.48302
Expected LPN Staffing Hours per Resident per Day
0.62175
Expected RN Staffing Hours per Resident per Day
0.90730
Expected Total Nurse Staffing Hours per Resident per Day
4.01208
Adjusted CNA Staffing Hours per Resident per Day
2.38615
Adjusted LPN Staffing Hours per Resident per Day
1.62033
Adjusted RN Staffing Hours per Resident per Day
0.51330
Adjusted Total Nurse Staffing Hours per Resident per Day
4.27168
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-07-16
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2012-10-11
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2011-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
2535
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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