Manorcare Health Services-fair Oaks - Fairfax Nursing Home

General Information

UPDATE
Federal Provider Number
495217
Provider Name
MANORCARE HEALTH SERVICES-FAIR OAKS
Provider Address
12475 LEE JACKSON MEMORIAL HIGHWAY
FAIRFAX, VA 22033
Provider Phone Number
(703) 352-7172
Provider SSA County
290
Provider County Name
Fairfax
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
155
Number of Residents in Certified Beds
132
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE-FAIR OAKS OF FAIRFAX VA LLC
Date First Approved to Provide Medicare and Medicaid services
1990-09-06
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.03902
Reported LPN Staffing Hours per Resident per Day
0.95227
Reported RN Staffing Hours per Resident per Day
1.00038
Reported Licensed Staffing Hours per Resident per Day
1.95265
Reported Total Nurse Staffing Hours per Resident per Day
3.99167
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16136
Expected CNA Staffing Hours per Resident per Day
2.65775
Expected LPN Staffing Hours per Resident per Day
0.71912
Expected RN Staffing Hours per Resident per Day
1.18301
Expected Total Nurse Staffing Hours per Resident per Day
4.55988
Adjusted CNA Staffing Hours per Resident per Day
1.88248
Adjusted LPN Staffing Hours per Resident per Day
1.09910
Adjusted RN Staffing Hours per Resident per Day
0.63185
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52861
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-05-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-04-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-03-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
62.66700
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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