Madison Manor Nursing Home
3891 Sullivan St, Madison, AL 35758


Madison Manor Nursing Home is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 015214. The address is 3891 Sullivan St, Madison, AL 35758. The zip code is 35758. The phone number is 2567729243.


Madison Manor Nursing Home · 3891 Sullivan St, Madison, AL 35758

Federal Provider Number 015214
Provider Name MADISON MANOR NURSING HOME
Address 3891 SULLIVAN ST
MADISON, AL 35758
Phone Number 2567729243
SSA County Code 440
County Name Madison
Ownership Type For profit - Corporation
Certified Beds 80
Certified Beds Residents 64
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name MADISON MANOR NURSING HOME LLC
Date First Approved to Provide Medicare Medicaid Services 08/01/1982
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council None
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 2
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.85703
Reported LPN Staffing Hours per Resident per Day 1.60703
Reported RN Staffing Hours per Resident per Day 0.80313
Reported Licensed Staffing Hours per Resident per Day 2.41016
Reported Total Nurse Staffing Hours per Resident per Day 5.26719
Reported Physical Therapist Staffing Hours per Resident Per Day 0.02656
Expected CNA Staffing Hours per Resident per Day 2.58871
Expected LPN Staffing Hours per Resident per Day 0.66519
Expected RN Staffing Hours per Resident per Day 1.09459
Expected Total Nurse Staffing Hours per Resident per Day 4.34848
Adjusted CNA Staffing Hours per Resident per Day 2.70803
Adjusted LPN Staffing Hours per Resident per Day 2.00519
Adjusted RN Staffing Hours per Resident per Day 0.54824
Adjusted Total Nurse Staffing Hours per Resident per Day 4.88251
Cycle 1 Total Number of Health Deficiencies 4
Cycle 1 Number of Standard Health Deficiencies 4
Cycle 1 Health Deficiency Score 20
Cycle 1 Standard Survey Health Date 06/01/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 20
Cycle 2 Total Number of Health Deficiencies 7
Cycle 2 Number of Standard Health Deficiencies 7
Cycle 2 Health Deficiency Score 32
Cycle 2 Standard Health Survey Date 06/16/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 32
Cycle 3 Total Number of Health Deficiencies 17
Cycle 3 Number of Standard Health Deficiencies 17
Cycle 3 Health Deficiency Score 136
Cycle 3 Standard Health Survey Date 04/24/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 136
Total Weighted Health Survey Score 43.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Madison Manor Nursing Home

Owner Name Role Association Date
CROWNE MANAGEMENT, LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/10/2009
CROWNE OPERATIONS, INC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/01/2003
DUNNAM, NOEL (Individual) OFFICER since 06/11/2015
JONES, JOSEPH (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/01/2003
JONES, JOSEPH (Individual) DIRECTOR since 12/01/2003
JONES, RICHARD (Individual) DIRECTOR since 12/01/2003
JONES, RICHARD (Individual) OFFICER since 06/11/2015
MANNING, MARCUS (Individual) OFFICER since 06/11/2015
MISENCIK, ROSEMARY (Individual) DIRECTOR since 12/01/2003
SMITH, FELITA (Individual) MANAGING EMPLOYEE since 11/01/2003
WILDER, JOHN (Individual) DIRECTOR since 12/01/2003

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