Roberta Health And Rehab - Roberta Nursing Home
General Information
UPDATEFederal Provider Number
115523
Provider Name
ROBERTA HEALTH AND REHAB
Provider Address
420 MYTLE DRIVE
ROBERTA, GA 31078
ROBERTA, GA 31078
Provider Phone Number
(478) 836-3101
Provider SSA County
330
Provider County Name
Crawford
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
89
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ROBERTA OPERATOR LLC
Date First Approved to Provide Medicare and Medicaid services
1992-06-11
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
1.78933
Reported LPN Staffing Hours per Resident per Day
0.97921
Reported RN Staffing Hours per Resident per Day
0.40225
Reported Licensed Staffing Hours per Resident per Day
1.38146
Reported Total Nurse Staffing Hours per Resident per Day
3.17079
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08034
Expected CNA Staffing Hours per Resident per Day
2.40620
Expected LPN Staffing Hours per Resident per Day
0.66265
Expected RN Staffing Hours per Resident per Day
1.12797
Expected Total Nurse Staffing Hours per Resident per Day
4.19681
Adjusted CNA Staffing Hours per Resident per Day
1.82466
Adjusted LPN Staffing Hours per Resident per Day
1.22651
Adjusted RN Staffing Hours per Resident per Day
0.26646
Adjusted Total Nurse Staffing Hours per Resident per Day
3.04544
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-09-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2012-11-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
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
36
Cycle 3 Standard Health Survey Date
2011-06-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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