Goodwin House Bailey's Crossroads - Falls Church Nursing Home
General Information
UPDATEFederal Provider Number
495171
Provider Name
GOODWIN HOUSE BAILEY'S CROSSROADS
Provider Address
3440 S JEFFERSON STREET
FALLS CHURCH, VA 22041
FALLS CHURCH, VA 22041
Provider Phone Number
(703) 578-7262
Provider SSA County
290
Provider County Name
Fairfax
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
73
Number of Residents in Certified Beds
63
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
1987-11-04
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
3.29762
Reported LPN Staffing Hours per Resident per Day
0.59524
Reported RN Staffing Hours per Resident per Day
1.56429
Reported Licensed Staffing Hours per Resident per Day
2.15952
Reported Total Nurse Staffing Hours per Resident per Day
5.45715
Reported Physical Therapist Staffing Hours per Resident Per Day
0.26270
Expected CNA Staffing Hours per Resident per Day
2.62645
Expected LPN Staffing Hours per Resident per Day
0.57014
Expected RN Staffing Hours per Resident per Day
0.85912
Expected Total Nurse Staffing Hours per Resident per Day
4.05572
Adjusted CNA Staffing Hours per Resident per Day
3.08072
Adjusted LPN Staffing Hours per Resident per Day
0.86654
Adjusted RN Staffing Hours per Resident per Day
1.36050
Adjusted Total Nurse Staffing Hours per Resident per Day
5.42376
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-09-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-11-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-10-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
33.33300
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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