Ross Memorial Health Care Ctr - Kennesaw Nursing Home
General Information
UPDATEFederal Provider Number
115515
Provider Name
ROSS MEMORIAL HEALTH CARE CTR
Provider Address
1780 OLD HIGHWAY 41
KENNESAW, GA 30152
KENNESAW, GA 30152
Provider Phone Number
(770) 427-7256
Provider SSA County
290
Provider County Name
Cobb
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHADY GROVE REST HOME INC
Date First Approved to Provide Medicare and Medicaid services
1991-10-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
2.85058
Reported LPN Staffing Hours per Resident per Day
0.92326
Reported RN Staffing Hours per Resident per Day
0.27267
Reported Licensed Staffing Hours per Resident per Day
1.19593
Reported Total Nurse Staffing Hours per Resident per Day
4.04651
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06628
Expected CNA Staffing Hours per Resident per Day
2.43043
Expected LPN Staffing Hours per Resident per Day
0.63460
Expected RN Staffing Hours per Resident per Day
1.00405
Expected Total Nurse Staffing Hours per Resident per Day
4.06908
Adjusted CNA Staffing Hours per Resident per Day
2.87788
Adjusted LPN Staffing Hours per Resident per Day
1.20754
Adjusted RN Staffing Hours per Resident per Day
0.20292
Adjusted Total Nurse Staffing Hours per Resident per Day
4.00854
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-05-30
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2011-11-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
7.33300
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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