Goodwin House Alexandria - Alexandria Nursing Home
General Information
UPDATEFederal Provider Number
495057
Provider Name
GOODWIN HOUSE ALEXANDRIA
Provider Address
4800 FILLMORE AVE
ALEXANDRIA, VA 22311
ALEXANDRIA, VA 22311
Provider Phone Number
(703) 824-1157
Provider SSA County
11
Provider County Name
Alexandria City
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
80
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOODWIN HOUSE INCORPORATED
Date First Approved to Provide Medicare and Medicaid services
1968-07-03
Continuing Care Retirement Community
Y
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
2.92313
Reported LPN Staffing Hours per Resident per Day
0.98500
Reported RN Staffing Hours per Resident per Day
1.03875
Reported Licensed Staffing Hours per Resident per Day
2.02375
Reported Total Nurse Staffing Hours per Resident per Day
4.94688
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06875
Expected CNA Staffing Hours per Resident per Day
2.43771
Expected LPN Staffing Hours per Resident per Day
0.55622
Expected RN Staffing Hours per Resident per Day
0.85624
Expected Total Nurse Staffing Hours per Resident per Day
3.85018
Adjusted CNA Staffing Hours per Resident per Day
2.94230
Adjusted LPN Staffing Hours per Resident per Day
1.46982
Adjusted RN Staffing Hours per Resident per Day
0.90647
Adjusted Total Nurse Staffing Hours per Resident per Day
5.17908
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-11-18
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
50
Cycle 1 Total Health Score
150
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-11-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-11-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
86.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
61913
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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