Shamrock Nursing & Rehab Ctr - Dublin Nursing Home
General Information
UPDATEFederal Provider Number
115495
Provider Name
SHAMROCK NURSING & REHAB CTR
Provider Address
1634 TELFAIR ST
DUBLIN, GA 31021
DUBLIN, GA 31021
Provider Phone Number
(478) 272-1133
Provider SSA County
660
Provider County Name
Laurens
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
94
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DELTA REGIONAL HOLDINGS LLC
Date First Approved to Provide Medicare and Medicaid services
1989-11-01
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
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
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.92553
Reported LPN Staffing Hours per Resident per Day
1.01011
Reported RN Staffing Hours per Resident per Day
0.38936
Reported Licensed Staffing Hours per Resident per Day
1.39947
Reported Total Nurse Staffing Hours per Resident per Day
3.32500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06064
Expected CNA Staffing Hours per Resident per Day
2.36629
Expected LPN Staffing Hours per Resident per Day
0.60385
Expected RN Staffing Hours per Resident per Day
0.98093
Expected Total Nurse Staffing Hours per Resident per Day
3.95107
Adjusted CNA Staffing Hours per Resident per Day
1.99666
Adjusted LPN Staffing Hours per Resident per Day
1.38840
Adjusted RN Staffing Hours per Resident per Day
0.29659
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39218
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
12
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2012-07-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
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
40
Cycle 3 Standard Health Survey Date
2010-12-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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