Forest Manor Inc - Northport Nursing Home
General Information
UPDATEFederal Provider Number
15143
Provider Name
FOREST MANOR INC
Provider Address
2215 32ND STREET
NORTHPORT, AL 35476
NORTHPORT, AL 35476
Provider Phone Number
(205) 339-5400
Provider SSA County
620
Provider County Name
Tuscaloosa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
182
Number of Residents in Certified Beds
158
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOREST MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
1976-08-01
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
1
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
3.32373
Reported LPN Staffing Hours per Resident per Day
1.58038
Reported RN Staffing Hours per Resident per Day
0.90886
Reported Licensed Staffing Hours per Resident per Day
2.48924
Reported Total Nurse Staffing Hours per Resident per Day
5.81297
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04146
Expected CNA Staffing Hours per Resident per Day
2.45646
Expected LPN Staffing Hours per Resident per Day
0.60833
Expected RN Staffing Hours per Resident per Day
0.93762
Expected Total Nurse Staffing Hours per Resident per Day
4.00241
Adjusted CNA Staffing Hours per Resident per Day
3.32000
Adjusted LPN Staffing Hours per Resident per Day
2.15627
Adjusted RN Staffing Hours per Resident per Day
0.72428
Adjusted Total Nurse Staffing Hours per Resident per Day
5.85435
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-08-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2013-07-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-05-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
43.33300
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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