Haralson Nsg & Rehab Center - Bremen Nursing Home
General Information
UPDATEFederal Provider Number
115431
Provider Name
HARALSON NSG & REHAB CENTER
Provider Address
315 FIELD STREET
BREMEN, GA 30110
BREMEN, GA 30110
Provider Phone Number
(770) 537-4482
Provider SSA County
570
Provider County Name
Haralson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
108
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HARALSON CYPRESS LLC
Date First Approved to Provide Medicare and Medicaid services
1989-10-01
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
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
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
1.75463
Reported LPN Staffing Hours per Resident per Day
0.83843
Reported RN Staffing Hours per Resident per Day
0.38380
Reported Licensed Staffing Hours per Resident per Day
1.22222
Reported Total Nurse Staffing Hours per Resident per Day
2.97686
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05278
Expected CNA Staffing Hours per Resident per Day
2.48980
Expected LPN Staffing Hours per Resident per Day
0.69642
Expected RN Staffing Hours per Resident per Day
1.22442
Expected Total Nurse Staffing Hours per Resident per Day
4.41064
Adjusted CNA Staffing Hours per Resident per Day
1.72919
Adjusted LPN Staffing Hours per Resident per Day
0.99924
Adjusted RN Staffing Hours per Resident per Day
0.23421
Adjusted Total Nurse Staffing Hours per Resident per Day
2.72056
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-04-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2012-08-09
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
12
Cycle 3 Standard Health Survey Date
2011-03-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
4.00000
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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