John Knox Manor Inc I I - Montgomery Nursing Home
General Information
UPDATEFederal Provider Number
15135
Provider Name
JOHN KNOX MANOR INC I I
Provider Address
4401 NARROW LANE ROAD
MONTGOMERY, AL 36116
MONTGOMERY, AL 36116
Provider Phone Number
(334) 281-6336
Provider SSA County
500
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
98
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JOHN KNOX MANOR INC II
Date First Approved to Provide Medicare and Medicaid services
1976-05-10
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.52923
Reported LPN Staffing Hours per Resident per Day
1.27462
Reported RN Staffing Hours per Resident per Day
0.39538
Reported Licensed Staffing Hours per Resident per Day
1.67000
Reported Total Nurse Staffing Hours per Resident per Day
4.19923
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01000
Expected CNA Staffing Hours per Resident per Day
2.44498
Expected LPN Staffing Hours per Resident per Day
0.54197
Expected RN Staffing Hours per Resident per Day
0.75068
Expected Total Nurse Staffing Hours per Resident per Day
3.73763
Adjusted CNA Staffing Hours per Resident per Day
2.53825
Adjusted LPN Staffing Hours per Resident per Day
1.95202
Adjusted RN Staffing Hours per Resident per Day
0.39354
Adjusted Total Nurse Staffing Hours per Resident per Day
4.52872
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
16
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
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
8
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-10-12
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
16.00000
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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