Knott County Health and Rehabilitation Center
388 Perkins Madden Road, Hindman, KY 41822


Knott County Health and Rehabilitation Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 185150. The address is 388 Perkins Madden Road, Hindman, KY 41822. The zip code is 41822. The phone number is 6067855011.


Knott County Health and Rehabilitation Center · 388 Perkins Madden Road, Hindman, KY 41822

Federal Provider Number 185150
Provider Name KNOTT COUNTY HEALTH AND REHABILITATION CENTER
Address 388 PERKINS MADDEN ROAD
HINDMAN, KY 41822
Phone Number 6067855011
SSA County Code 590
County Name Knott
Ownership Type For profit - Corporation
Certified Beds 92
Certified Beds Residents 89
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name KNOTT COUNTY NURSING HOME, INC.
Date First Approved to Provide Medicare Medicaid Services 06/22/1978
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 Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 4
Quality Measure Rating 3
Staffing Rating 2
RN Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 2.39607
Reported LPN Staffing Hours per Resident per Day 0.67416
Reported RN Staffing Hours per Resident per Day 0.62865
Reported Licensed Staffing Hours per Resident per Day 1.30281
Reported Total Nurse Staffing Hours per Resident per Day 3.69888
Reported Physical Therapist Staffing Hours per Resident Per Day 0.06011
Expected CNA Staffing Hours per Resident per Day 2.45684
Expected LPN Staffing Hours per Resident per Day 0.75675
Expected RN Staffing Hours per Resident per Day 1.30159
Expected Total Nurse Staffing Hours per Resident per Day 4.51517
Adjusted CNA Staffing Hours per Resident per Day 2.39301
Adjusted LPN Staffing Hours per Resident per Day 0.73942
Adjusted RN Staffing Hours per Resident per Day 0.36089
Adjusted Total Nurse Staffing Hours per Resident per Day 3.30216
Cycle 1 Standard Survey Health Date 03/15/2017
Cycle 2 Total Number of Health Deficiencies 4
Cycle 2 Number of Standard Health Deficiencies 1
Cycle 2 Number of Complaint Health Deficiencies 3
Cycle 2 Health Deficiency Score 16
Cycle 2 Standard Health Survey Date 01/28/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 16
Cycle 3 Total Number of Health Deficiencies 4
Cycle 3 Number of Standard Health Deficiencies 4
Cycle 3 Health Deficiency Score 24
Cycle 3 Standard Health Survey Date 12/11/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 24
Total Weighted Health Survey Score 9.333
Number of Substantiated Complaints 2
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Knott County Health and Rehabilitation Center

Owner Name Role Association Date
ALSIP, ROGER (Individual) OFFICER since 01/01/2011
ARNOLD, SUSAN (Individual) DIRECTOR since 01/01/2011
FIRST CORBIN LONG TERM CARE INC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 07/01/2003
FORCHT, TERRY (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
99%
since 07/01/2003
HALL, KATHY (Individual) DIRECTOR since 01/01/2011
HALL, KATHY (Individual) OFFICER since 01/01/2011
JARBOE, MICHELLE (Individual) DIRECTOR since 01/01/2011
PIGMAN, RUBY (Individual) OPERATIONAL/MANAGERIAL CONTROL since 05/22/2009
WILLIS, JACKIE (Individual) OFFICER since 01/01/2011
WITT, DAVID (Individual) OFFICER since 01/01/2011

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