The Jefferson - Arlington Nursing Home
General Information
UPDATEFederal Provider Number
495269
Provider Name
THE JEFFERSON
Provider Address
900 NORTH TAYLOR STREET
ARLINGTON, VA 22203
ARLINGTON, VA 22203
Provider Phone Number
(703) 741-7582
Provider SSA County
60
Provider County Name
Arlington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
31
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SUNRISE SENIOR LIVING SERVICES, INC
Date First Approved to Provide Medicare and Medicaid services
1992-10-21
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
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
2.43929
Reported LPN Staffing Hours per Resident per Day
0.82321
Reported RN Staffing Hours per Resident per Day
1.26071
Reported Licensed Staffing Hours per Resident per Day
2.08393
Reported Total Nurse Staffing Hours per Resident per Day
4.52321
Reported Physical Therapist Staffing Hours per Resident Per Day
0.63750
Expected CNA Staffing Hours per Resident per Day
2.44318
Expected LPN Staffing Hours per Resident per Day
0.75440
Expected RN Staffing Hours per Resident per Day
1.58714
Expected Total Nurse Staffing Hours per Resident per Day
4.78471
Adjusted CNA Staffing Hours per Resident per Day
2.44979
Adjusted LPN Staffing Hours per Resident per Day
0.90571
Adjusted RN Staffing Hours per Resident per Day
0.59352
Adjusted Total Nurse Staffing Hours per Resident per Day
3.81059
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
32
Cycle 1 Standard Survey Health Date
2015-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2014-02-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-02-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
31.33300
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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