Pruitthealth - Lilburn - Lilburn Nursing Home
General Information
UPDATEFederal Provider Number
115516
Provider Name
PRUITTHEALTH - LILBURN
Provider Address
788 INDIAN TRAIL ROAD
LILBURN, GA 30047
LILBURN, GA 30047
Provider Phone Number
7709232020
Provider SSA County
530
Provider County Name
Gwinnett
Ownership Type
For profit - Corporation
Number of Certified Beds
152
Number of Residents in Certified Beds
136
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRUITTHEALTH-LILBURN LLC
Date First Approved to Provide Medicare and Medicaid services
1991-06-01
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
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.13199
Reported LPN Staffing Hours per Resident per Day
0.62757
Reported RN Staffing Hours per Resident per Day
0.82316
Reported Licensed Staffing Hours per Resident per Day
1.45074
Reported Total Nurse Staffing Hours per Resident per Day
3.58272
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04485
Expected CNA Staffing Hours per Resident per Day
2.63592
Expected LPN Staffing Hours per Resident per Day
0.71266
Expected RN Staffing Hours per Resident per Day
1.11218
Expected Total Nurse Staffing Hours per Resident per Day
4.46077
Adjusted CNA Staffing Hours per Resident per Day
1.98461
Adjusted LPN Staffing Hours per Resident per Day
0.73090
Adjusted RN Staffing Hours per Resident per Day
0.55303
Adjusted Total Nurse Staffing Hours per Resident per Day
3.23747
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-03-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-09-12
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
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-03-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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