Hazelhurst Center - Hazlehurst Nursing Home
General Information
UPDATEFederal Provider Number
115626
Provider Name
HAZELHURST CENTER
Provider Address
180 BURKETT FERRY ROAD
HAZLEHURST, GA 31539
HAZLEHURST, GA 31539
Provider Phone Number
(912) 375-3677
Provider SSA County
612
Provider County Name
Jeff Davis
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
73
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SUNBRIDGE JEFF DAVIS HEALTHCARE LLC
Date First Approved to Provide Medicare and Medicaid services
1997-01-01
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
2
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
1.76866
Reported LPN Staffing Hours per Resident per Day
0.76940
Reported RN Staffing Hours per Resident per Day
0.45821
Reported Licensed Staffing Hours per Resident per Day
1.22761
Reported Total Nurse Staffing Hours per Resident per Day
2.99627
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14701
Expected CNA Staffing Hours per Resident per Day
2.36207
Expected LPN Staffing Hours per Resident per Day
0.69303
Expected RN Staffing Hours per Resident per Day
1.33495
Expected Total Nurse Staffing Hours per Resident per Day
4.39005
Adjusted CNA Staffing Hours per Resident per Day
1.83727
Adjusted LPN Staffing Hours per Resident per Day
0.92147
Adjusted RN Staffing Hours per Resident per Day
0.25647
Adjusted Total Nurse Staffing Hours per Resident per Day
2.75114
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
20
Cycle 1 Standard Survey Health Date
2015-01-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
12
Cycle 2 Standard Health Survey Date
2013-04-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2011-12-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
24.00000
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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