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Fort Valley Health And Rehab - Fort Valley Nursing Home

General Information

UPDATE
Federal Provider Number
115651
Provider Name
FORT VALLEY HEALTH AND REHAB
Provider Address
604 BLUEBIRD BOULEVARD
FORT VALLEY, GA 31030
Provider Phone Number
(478) 825-2031
Provider SSA County
811
Provider County Name
Peach
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
75
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FORT VALLEY OPERATOR LLC
Date First Approved to Provide Medicare and Medicaid services
1998-07-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
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
1.70896
Reported LPN Staffing Hours per Resident per Day
0.84627
Reported RN Staffing Hours per Resident per Day
0.44925
Reported Licensed Staffing Hours per Resident per Day
1.29552
Reported Total Nurse Staffing Hours per Resident per Day
3.00448
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08134
Expected CNA Staffing Hours per Resident per Day
2.35807
Expected LPN Staffing Hours per Resident per Day
0.75764
Expected RN Staffing Hours per Resident per Day
1.24804
Expected Total Nurse Staffing Hours per Resident per Day
4.36375
Adjusted CNA Staffing Hours per Resident per Day
1.77827
Adjusted LPN Staffing Hours per Resident per Day
0.92710
Adjusted RN Staffing Hours per Resident per Day
0.26897
Adjusted Total Nurse Staffing Hours per Resident per Day
2.77531
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-03-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-09-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-03-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
35.33300
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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