FACILITY NAME
CONSUMER REPORT
Created on: (Date this report was generated) Posted to the web on: (Date this report was posted on the web site) Facility Profile
Basic Information
Address: (Address of the facility)
City: (City of the facility)
Telephone: (Phone number for the facility)
View location on map (displays facilities location in google maps if available)
Most recent name change: (Previous name of the facility, if changed)
Date of most recent name change: (Date name was last changed)
Facility License number: (License number on file if applicaable)
Facility License effective date: (Date license became effective)
Facility License expiration date: (Date license expires)
Administrator: (Name of the administrator)
Administrator start date: (Date the administrator started here)
DON: (Name of the director of nursing)
DON start date: (Date the director of nursing started here)
Beds
# of Medicaid beds (NF): (Number of title 19 beds)
# of Medicare beds (SNF): (Number of title 18 beds)
# of Medicare/Medicaid beds (SNF/NF): (Number of title 18/19 beds)
Total number of comprehensive care beds: (Number of comprehensive
beds - beds which are reimbursed by Medicare and/or Medicaid)
# of non-certified comprehensive care beds:
(Number of non-certified comprehensive beds - beds not
reimbursed by Medicare and/or Medicaid)
Total number of residential beds: (Number of residential beds)
Total number of beds in facility: (Total number of facility beds)
Facility census: (Number of residents in facility, and date reported.
This is not available (N/A) for non-certified comprehensive care
facilities.)
Owning corporation: (Name and address of the corporation that owns the facility)
Ownership type: (for profit, not for profit, government etc.)
Officer(s): (Name(s) of officers of the corporation)
Name of previous owner: (Name of previous owner, if any)
Date of last change of ownership: (Date of last ownership change)
This facility is: (sprinklered, partially sprinklered, etc. type of sprinkler system)
Number of comprehensive care resident rooms: (number of resident rooms)
Number of comprehensive care resident rooms with battery
operated single station smoke alarms: (number of rooms with battery operated smoke alarms)
Number of comprehensive care resident rooms
with system based smoke alarms: (number of rooms with system based smoke alarms)
Number of common areas in comprehensive care area: (number of common areas in the comprehensive care area)
Number of common areas in comprehensive care area with battery
operated single station smoke alarms: (number of common areas with battery operated smoke detectors)
Number of common areas in comprehensive care area
with system based smoke alarms: (number of common areas with system based smoke detectors)
Nurse Aide Training Competency Evaluation Program (NATCEP)
NATCEP approved: (Date approved to provide classroom training to nurse aide students, if applicable)
NATCEP expires: (Date of expiration of classroom training authorization, if applicable)
NATCEP banned: (Date banned from classroom training of nurse aides, if applicable)
This facility is a Clinical training site for the following NAT classroom sites:
(If this facility provides clinical nurse aide training then a listing will
be displayed showing the facility that provides the classroom training, the
date this facility was approved to perform the clinical training for that
facility if available, and the date this facility was terminated as a clinical site if applicable.)
If this is a certified facility you will see a report card score and state average scores for the last three annual surveys
conducted for this facility.
If this is a residential facility you will see a report showing the number of tags cited and state averages of the number
of tags cited for the last three licensure surveys conducted for this facility.
Survey history: A grid showing the last several years of surveys for the facility showing eventid, survey type, and exit
date. If the survey report is available the eventid will be a link to that report.
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