Woodstock Nursing & Rehab Ctr - Woodstock Nursing Home
General Information
UPDATEFederal Provider Number
115421
Provider Name
WOODSTOCK NURSING & REHAB CTR
Provider Address
105 ARNOLD MILL ROAD
WOODSTOCK, GA 30188
WOODSTOCK, GA 30188
Provider Phone Number
(770) 926-0016
Provider SSA County
250
Provider County Name
Cherokee
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
171
Number of Residents in Certified Beds
114
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WOODSTOCK CYPRESS LLC
Date First Approved to Provide Medicare and Medicaid services
1989-07-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.27412
Reported LPN Staffing Hours per Resident per Day
1.13772
Reported RN Staffing Hours per Resident per Day
0.72105
Reported Licensed Staffing Hours per Resident per Day
1.85877
Reported Total Nurse Staffing Hours per Resident per Day
4.13289
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03904
Expected CNA Staffing Hours per Resident per Day
2.47229
Expected LPN Staffing Hours per Resident per Day
0.64671
Expected RN Staffing Hours per Resident per Day
1.08243
Expected Total Nurse Staffing Hours per Resident per Day
4.20144
Adjusted CNA Staffing Hours per Resident per Day
2.25702
Adjusted LPN Staffing Hours per Resident per Day
1.46016
Adjusted RN Staffing Hours per Resident per Day
0.49774
Adjusted Total Nurse Staffing Hours per Resident per Day
3.96513
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
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
20
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
2013-04-04
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
2
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-10-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
18.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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