Williamsburg Health And Rehabilitation Center - Williamsburg Nursing Home
General Information
UPDATEFederal Provider Number
185148
Provider Name
WILLIAMSBURG HEALTH AND REHABILITATION CENTER
Provider Address
287 N ELEVENTH ST
WILLIAMSBURG, KY 40769
WILLIAMSBURG, KY 40769
Provider Phone Number
(606) 549-4321
Provider SSA County
990
Provider County Name
Whitley
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
125
Number of Residents in Certified Beds
124
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WILLIAMSBURG NURSING HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1978-04-12
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
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
2.52944
Reported LPN Staffing Hours per Resident per Day
0.86452
Reported RN Staffing Hours per Resident per Day
0.53669
Reported Licensed Staffing Hours per Resident per Day
1.40121
Reported Total Nurse Staffing Hours per Resident per Day
3.93065
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16935
Expected CNA Staffing Hours per Resident per Day
2.60376
Expected LPN Staffing Hours per Resident per Day
0.72013
Expected RN Staffing Hours per Resident per Day
1.30515
Expected Total Nurse Staffing Hours per Resident per Day
4.62905
Adjusted CNA Staffing Hours per Resident per Day
2.38366
Adjusted LPN Staffing Hours per Resident per Day
0.99642
Adjusted RN Staffing Hours per Resident per Day
0.30725
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42275
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
2015-01-08
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
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
16
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
12.66700
Number of Facility Reported Incidents
1
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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