Jefferson Manor Health & Rehabilitation Center - Louisville Nursing Home
General Information
UPDATEFederal Provider Number
185169
Provider Name
JEFFERSON MANOR HEALTH & REHABILITATION CENTER
Provider Address
1801 LYNN WAY
LOUISVILLE, KY 40222
LOUISVILLE, KY 40222
Provider Phone Number
(502) 426-4513
Provider SSA County
550
Provider County Name
Jefferson
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
100
Number of Residents in Certified Beds
89
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NEW JEFFERSON MANOR, LLC
Date First Approved to Provide Medicare and Medicaid services
1982-09-02
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
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.37584
Reported LPN Staffing Hours per Resident per Day
0.93820
Reported RN Staffing Hours per Resident per Day
0.80449
Reported Licensed Staffing Hours per Resident per Day
1.74270
Reported Total Nurse Staffing Hours per Resident per Day
4.11853
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08483
Expected CNA Staffing Hours per Resident per Day
2.59890
Expected LPN Staffing Hours per Resident per Day
0.63417
Expected RN Staffing Hours per Resident per Day
0.95846
Expected Total Nurse Staffing Hours per Resident per Day
4.19154
Adjusted CNA Staffing Hours per Resident per Day
2.24310
Adjusted LPN Staffing Hours per Resident per Day
1.22790
Adjusted RN Staffing Hours per Resident per Day
0.62717
Adjusted Total Nurse Staffing Hours per Resident per Day
3.96069
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-11-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
16
Cycle 2 Standard Health Survey Date
2013-09-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
48
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
19.33300
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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