Brandon Wilde Pavilion
4275 Owens Road, Evans, GA 30809

Brandon Wilde Pavilion is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 115524. The address is 4275 Owens Road, Evans, GA 30809. The zip code is 30809. The phone number is 7068689800.

Brandon Wilde Pavilion · 4275 Owens Road, Evans, GA 30809

Federal Provider Number 115524
Address 4275 OWENS ROAD
EVANS, GA 30809
Phone Number 7068689800
SSA County Code 310
County Name Columbia
Ownership Type Non profit - Corporation
Certified Beds 65
Certified Beds Residents 55
Provider Type Medicare
Resides in Hospital false
Date First Approved to Provide Medicare Medicaid Services 06/17/1992
Continuing Care Retirement Community true
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 5
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.52
Reported LPN Staffing Hours per Resident per Day 1.11636
Reported RN Staffing Hours per Resident per Day 0.69273
Reported Licensed Staffing Hours per Resident per Day 1.80909
Reported Total Nurse Staffing Hours per Resident per Day 4.32909
Reported Physical Therapist Staffing Hours per Resident Per Day 0.10273
Expected CNA Staffing Hours per Resident per Day 2.59259
Expected LPN Staffing Hours per Resident per Day 0.59102
Expected RN Staffing Hours per Resident per Day 0.97495
Expected Total Nurse Staffing Hours per Resident per Day 4.15856
Adjusted CNA Staffing Hours per Resident per Day 2.385
Adjusted LPN Staffing Hours per Resident per Day 1.56776
Adjusted RN Staffing Hours per Resident per Day 0.53091
Adjusted Total Nurse Staffing Hours per Resident per Day 4.1962
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 8
Cycle 1 Standard Survey Health Date 02/18/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 8
Cycle 2 Standard Health Survey Date 01/22/2015
Cycle 3 Standard Health Survey Date 05/08/2013
Total Weighted Health Survey Score 4
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Brandon Wilde Pavilion

Owner Name Role Association Date
BELKOSKI, DAVID (Individual) OFFICER since 01/01/2008
BOWCUTT, MARILYN (Individual) OFFICER since 12/01/2014
DAVIS, JAMES (Individual) OFFICER since 06/01/2010
DOZIER, TOM (Individual) OFFICER since 03/01/1994
KAUFFMAN, PAMELA (Individual) MANAGING EMPLOYEE since 05/02/2015
MARSHALL, BRUCE (Individual) MANAGING EMPLOYEE since 08/19/2013
MATHEIS, GERALD (Individual) OFFICER since 01/01/2012
MOYE, WILLIAM (Individual) OFFICER since 01/01/2013
since 06/08/2010
WOODARD, ANDREA (Individual) MANAGING EMPLOYEE since 06/08/2010

30809 · Nursing Home

University Extended Care/westw 561 University Drive, Evans, GA 30809

Evans · Nursing Home

University Extended Care/westw 561 University Drive, Evans, GA 30809

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