Keysville Nursing Home & Rehab Center - Keysville Nursing Home
General Information
UPDATEFederal Provider Number
115644
Provider Name
KEYSVILLE NURSING HOME & REHAB CENTER
Provider Address
1005 HWY. 88 NORTH
KEYSVILLE, GA 30816
KEYSVILLE, GA 30816
Provider Phone Number
7065472591
Provider SSA County
150
Provider County Name
Burke
Ownership Type
For profit - Individual
Number of Certified Beds
64
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GIBSON HEALTH CARE LLC
Date First Approved to Provide Medicare and Medicaid services
1996-11-25
Continuing Care Retirement Community
N
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.88700
Reported LPN Staffing Hours per Resident per Day
1.10200
Reported RN Staffing Hours per Resident per Day
0.41700
Reported Licensed Staffing Hours per Resident per Day
1.51900
Reported Total Nurse Staffing Hours per Resident per Day
3.40600
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01700
Expected CNA Staffing Hours per Resident per Day
2.49268
Expected LPN Staffing Hours per Resident per Day
0.70153
Expected RN Staffing Hours per Resident per Day
0.99608
Expected Total Nurse Staffing Hours per Resident per Day
4.19029
Adjusted CNA Staffing Hours per Resident per Day
1.85749
Adjusted LPN Staffing Hours per Resident per Day
1.30381
Adjusted RN Staffing Hours per Resident per Day
0.31281
Adjusted Total Nurse Staffing Hours per Resident per Day
3.27644
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
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
2012-12-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2011-08-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
56.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
11250
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Brentwood Health And Rehabilitation
115 Brentwood Drive |
WAYNESBORO GA 30830 | 17.4 miles away
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