Liberty Nursing Center Of Jamestown - Jamestown Nursing Home

General Information

UPDATE
Federal Provider Number
365368
Provider Name
LIBERTY NURSING CENTER OF JAMESTOWN
Provider Address
4960 US 35 EAST
JAMESTOWN, OH 45335
Provider Phone Number
(937) 675-3311
Provider SSA County
290
Provider County Name
Greene
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
43
Number of Residents in Certified Beds
33
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY NURSING CENTER OF JAMESTOWN
Date First Approved to Provide Medicare and Medicaid services
1977-11-01
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
3
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
2.58485
Reported LPN Staffing Hours per Resident per Day
0.86364
Reported RN Staffing Hours per Resident per Day
0.67424
Reported Licensed Staffing Hours per Resident per Day
1.53788
Reported Total Nurse Staffing Hours per Resident per Day
4.12273
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04091
Expected CNA Staffing Hours per Resident per Day
2.49999
Expected LPN Staffing Hours per Resident per Day
0.71241
Expected RN Staffing Hours per Resident per Day
1.50415
Expected Total Nurse Staffing Hours per Resident per Day
4.71655
Adjusted CNA Staffing Hours per Resident per Day
2.53698
Adjusted LPN Staffing Hours per Resident per Day
1.00619
Adjusted RN Staffing Hours per Resident per Day
0.33494
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52340
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-01-22
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
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-09-26
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
17.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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