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Fort Gaines Health And Rehab - Fort Gaines Nursing Home

General Information

UPDATE
Federal Provider Number
115696
Provider Name
FORT GAINES HEALTH AND REHAB
Provider Address
101 HARTFORD ROAD, WEST
FORT GAINES, GA 39851
Provider Phone Number
2297682521
Provider SSA County
270
Provider County Name
Clay
Ownership Type
For profit - Partnership
Number of Certified Beds
60
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FORT GAINES OPERATOR LLC
Date First Approved to Provide Medicare and Medicaid services
2005-06-10
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.38125
Reported LPN Staffing Hours per Resident per Day
1.24821
Reported RN Staffing Hours per Resident per Day
0.33750
Reported Licensed Staffing Hours per Resident per Day
1.58571
Reported Total Nurse Staffing Hours per Resident per Day
3.96696
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09196
Expected CNA Staffing Hours per Resident per Day
2.56602
Expected LPN Staffing Hours per Resident per Day
0.70858
Expected RN Staffing Hours per Resident per Day
1.19694
Expected Total Nurse Staffing Hours per Resident per Day
4.47154
Adjusted CNA Staffing Hours per Resident per Day
2.27702
Adjusted LPN Staffing Hours per Resident per Day
1.46210
Adjusted RN Staffing Hours per Resident per Day
0.21069
Adjusted Total Nurse Staffing Hours per Resident per Day
3.57605
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
1
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
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2012-11-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
36
Cycle 3 Standard Health Survey Date
2011-06-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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