Gilmer Nursing Home - Ellijay Nursing Home
General Information
UPDATEFederal Provider Number
115683
Provider Name
GILMER NURSING HOME
Provider Address
1362 SOUTH MAIN STREET
ELLIJAY, GA 30540
ELLIJAY, GA 30540
Provider Phone Number
(706) 276-4741
Provider SSA County
471
Provider County Name
Gilmer
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
SOUTHERN HEALTH CORP OF ELLIJAY
Date First Approved to Provide Medicare and Medicaid services
2003-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.56856
Reported LPN Staffing Hours per Resident per Day
1.00722
Reported RN Staffing Hours per Resident per Day
0.32371
Reported Licensed Staffing Hours per Resident per Day
1.33093
Reported Total Nurse Staffing Hours per Resident per Day
3.89949
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05876
Expected CNA Staffing Hours per Resident per Day
2.50097
Expected LPN Staffing Hours per Resident per Day
0.58637
Expected RN Staffing Hours per Resident per Day
0.81902
Expected Total Nurse Staffing Hours per Resident per Day
3.90636
Adjusted CNA Staffing Hours per Resident per Day
2.52001
Adjusted LPN Staffing Hours per Resident per Day
1.42571
Adjusted RN Staffing Hours per Resident per Day
0.29532
Adjusted Total Nurse Staffing Hours per Resident per Day
4.02381
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
2015-03-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-11-07
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-03-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
6.66700
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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