Providence Healthcare Of Thomaston - Thomaston Nursing Home
General Information
UPDATEFederal Provider Number
115484
Provider Name
PROVIDENCE HEALTHCARE OF THOMASTON
Provider Address
1011 SOUTH GREEN STREET
THOMASTON, GA 30286
THOMASTON, GA 30286
Provider Phone Number
(706) 647-6693
Provider SSA County
920
Provider County Name
Upson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
110
Number of Residents in Certified Beds
94
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GREEN STREET NH, LLC
Date First Approved to Provide Medicare and Medicaid services
1989-10-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.70266
Reported LPN Staffing Hours per Resident per Day
0.91277
Reported RN Staffing Hours per Resident per Day
0.27128
Reported Licensed Staffing Hours per Resident per Day
1.18404
Reported Total Nurse Staffing Hours per Resident per Day
2.88671
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06064
Expected CNA Staffing Hours per Resident per Day
2.26924
Expected LPN Staffing Hours per Resident per Day
0.59116
Expected RN Staffing Hours per Resident per Day
0.95448
Expected Total Nurse Staffing Hours per Resident per Day
3.81487
Adjusted CNA Staffing Hours per Resident per Day
1.84107
Adjusted LPN Staffing Hours per Resident per Day
1.28156
Adjusted RN Staffing Hours per Resident per Day
0.21237
Adjusted Total Nurse Staffing Hours per Resident per Day
3.05018
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-08-14
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
20
Cycle 1 Total Health Score
60
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
12
Cycle 2 Standard Health Survey Date
2012-10-12
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2011-04-14
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
13507
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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