Comprehensive Information on Georgia Nursing Homes
Report Card Number
Provider CCN
Facility Name
Street Address
City
State Code
Zip Code
County
Medicare CBSA Number
Rural versus Urban
Fiscal Year Begin Date
Fiscal Year End Date
Type of Control
Total Maternal and Child Health Days
Total Medicare Days
Total Medicaid Days
Total Days Other
Total Days Total
Number of Beds
Total Bed Days Available
Total Maternal and Child Health Discharges
Total Medicare Discharges
Total Medicaid Discharges
Total Discharges Title Other
Total Discharges Total
SNF Average Maternal and Child Health Stay
SNF Average Medicare Stay
SNF Average Medicaid Stay
SNF Average Length of Stay Total
SNF Maternal and Child Health Admissions
SNF Medicare Admissions
SNF Medicaid Admissions
SNF Admissions Other
SNF Admissions Total
SNF Maternal and Child Health Days
SNF Medicare Days
SNF Medicaid Days
SNF Days Other
SNF Days Total
SNF Number of Beds
SNF Bed Days Available
SNF Maternal and Child Health Discharges
SNF Medicare Discharges
SNF Medicaid Discharges
SNF Discharges Title Other
SNF Discharges Total
NF Number of Beds
NF Bed Days Available
NF Maternal and Child Health Days
NF Medicaid Days
NF Days Other
NF Days Total
NF Maternal and Child Health Discharges
NF Medicaid Discharges
NF Discharges Title Other
NF Discharges Total
NF Average Maternal and Child Health Stay
NF Average Medicaid Stay
NF Average Length of Stay Total
NF Maternal and Child Health Admissions
NF Medicaid Admissions
NF Admissions Other
NF Admissions Total
Total RUG Days
Total Salaries From Worksheet A
Overhead Non-Salary Costs
Total Charges
Total Costs
Wage-related Costs (core)
Total Salaries (adjusted)
Contract Labor
Cash on hand and in banks
Temporary Investments
Notes Receivable
Accounts Receivable
Less: Allowances for uncollectible notes and accounts receivable
Inventory
Prepaid expenses
Other current assets
Total Current Assets
Land
Land improvements
Buildings
Leasehold improvements
Fixed equipment
Major movable equipment
Minor equipment depreciable
Total fixed Assets
Investments
Other Assets
Total other Assets
Total Assets
Accounts payable
Salaries, wages, and fees payable
Payroll taxes payable
Notes and Loans Payable (short term)
Deferred income
Other current liabilities
Total current liabilities
Mortgage payable
Notes Payable
Unsecured Loans
Other long term liabilities
Total long term liabilities
Total liabilities
General fund balance
Total fund balances
Total Liabilities and fund balances
Total General Inpatient Care Services Revenue
Inpatient Revenue
Outpatient Revenue
Gross Revenue
Less Contractual Allowance and discounts on patients’ accounts
Net Patient Revenue
Less Total Operating Expense
Net Income from service to patients
Total Other Income
Total Income
Net Income
Inpatient PPS Amount
Nursing and Allied Health Education Activities
Allowable Bad Debts
1372664
115452
PRUITTHEALTH – SHEPHERD HILLS LLC
800 PATTERSON ROAD
LAFAYETTE
GA
30728
WALKER
16860
U
2022-07-01
2023-06-30
6
1172
26490
9499
37161
112
40880
26
31
61
118
45.08
854.52
314.92
28
13
64
105
1172
26490
9499
37161
112
40880
26
31
61
118
4457243
5218857
868305
892639
549633
4457243
95751
864350
411518
6643
1523791
40595
580023
445444
345096
440764
161
161
1964716
443767
458840
1303
15693
919603
919603
1045113
1045113
1964716
10476739
11345044
11345044
2432814
8912230
9676100
-763870
285348
-478522
-478522
663972
51526
1372971
115304
PRUITTHEALTH – LAFAYETTE LLC
205 ROADRUNNER BOULEVARD
LAFAYETTE
GA
30728
WALKER
16860
U
2022-07-01
2023-06-30
6
349
20866
6070
27285
100
36500
7
33
59
99
49.86
632.3
275.61
9
18
61
88
349
20866
6070
27285
100
36500
7
33
59
99
2953824
4088433
720505
741188
375804
2953824
74083
606526
324599
4929
-815114
95180
275536
306134
256213
12553
12553
-546348
352631
311531
200
13060
677422
677422
-1223770
-1223770
-546348
7154254
7874758
7874758
1865523
6009235
7042257
-1033022
137266
-895756
-895756
196492
7780
1357724
115532
SOCIAL CIRCLE NSG & REHAB CTR
671 NORTH CHEROKEE ROAD
SOCIAL CIRCLE
GA
30025-2886
WALTON
12060
U
2022-01-01
2022-12-31
6
1838
13812
3549
19199
65
23725
53
118
119
290
34.68
117.05
66.2
46
51
107
204
1838
13812
3549
19199
65
23725
53
118
119
290
1262029
4918788
2164191
655079
310198
1262029
9855
718781
126214
987048
426287
216896
7722
7722
1211666
368630
786917
1155547
642217
642217
1797764
-586098
-586098
1211666
6185689
8349880
8349880
2479966
5869914
6352843
-482929
632
-482297
-482297
1084790
181722
1371344
115005
PARK PLACE NURSING FACILITY
1865 BOLD SPRINGS
MONROE
GA
30655
WALTON
12060
U
2022-07-01
2023-06-30
4
14585
32680
9741
57006
165
60225
322
102
289
713
45.3
320.39
79.95
378
27
316
721
14585
32680
9741
57006
165
60225
322
102
289
713
9200660
14072227
3294432
3088548
1543353
9200660
2232171
3735127
283213
169751
-1210213
2838411
2838411
1926817
339846
21378
-1202294
1085747
1085747
1752664
1752664
2838411
21325663
24620095
24620095
2891382
21728713
23630687
-1901974
2239240
337266
337266
9693672
481653
1353753
115265
HARBORVIEW SATILLA
1600 RIVERSIDE AVENUE
WAYCROSS
GA
31501
WARE
99911
R
2022-01-01
2022-12-31
4
9804
38470
9139
57413
174
63510
201
601
294
1096
48.78
64.01
52.38
324
437
288
1049
9804
38470
9139
57413
174
63510
201
601
294
1096
7229052
8473290
2869619
1389459
1442899
7229052
1262382
1474141
45239
259053
3018702
677544
874908
999199
1744856
1744856
5762757
979894
550562
-175
172795
-297431
1405645
1405645
4357112
4357112
5762757
16986271
19855890
19855890
2245248
17610642
16120358
1490284
1252309
2742593
2742593
4407438
767432
1368813
115605
WAYCROSS HEALTH AND REHABILITATION
1910 DOROTHY STREET
WAYCROSS
GA
31501
WARE
99911
R
2022-07-01
2023-06-30
2
1026
17703
18729
92
33580
26
65
91
39.46
205.81
32
67
99
1026
17703
18729
92
33580
26
65
91
2627984
2680158
519421
508952
434312
2627984
163984
1201
440862
6005
2617965
147561
182496
80468
1232207
1232207
3930640
47634
90566
1232475
1379718
1379718
2550922
2550922
3930640
4113544
4632966
4632966
196186
4436780
5308142
-871362
117327
-754035
-754035
521349
42110
1371580
115615
BAPTIST VILLAGE INC.
2650 CARSWELL AVE
WAYCROSS
GA
31503
WARE
99911
R
2022-07-01
2023-06-30
1
4551
61408
65959
254
92710
98
260
358
46.44
184.24
110
256
366
4551
61408
65959
254
92710
98
260
358
9033116
13010906
1822534
1462172
2398183
9033116
2993102
38223088
1669759
206860
186554
2290
39875716
933092
16261433
1889543
562257
8518272
48393988
1225
339963
442
2290
343920
56158564
56502484
-8108496
-8108496
48393988
17131682
18954215
18954215
1040168
17914047
22044022
-4129975
644265
-3485710
-3485710
2297181
78283
1368305
115321
SELECTIS WARRENTON LLC
813 ATLANTA HWY
WARRENTON
GA
30828
WARREN
99911
R
2022-07-01
2023-06-30
5
1615
16126
1380
19121
110
40150
28
130
55
213
57.68
124.05
89.77
52
95
49
196
1615
16126
1380
19121
110
40150
28
130
55
213
2909999
2840858
1642702
539483
350779
2909999
424589
307982
82758
12430
105678
767921
14500
10150
21908
789829
191247
127512
9201
1774489
2102449
2102449
-1312620
-1312620
789829
3997141
5639843
5639843
1051913
4587930
5981541
-1393611
281491
-1112120
-1112120
946689
355665
1368150
115357
OCONEE HEALTH AND REHABILITATION
107 RIDGEVIEW DRIVE
OCONEE
GA
31067
WASHINGTON
99911
R
2022-07-01
2023-03-29
2
203
8561
8764
50
13600
4
56
60
50.75
146.07
6
20
26
203
8561
8764
50
13600
4
56
60
1559170
1222638
121035
75939
308031
1559170
52291
289540
242108
1086245
1086245
-8576
-15607
-15607
1101852
1101852
1086245
2113159
2234194
2234194
232680
2001514
2781808
-780294
-201520
-981814
-981814
109573
11038
1370056
115691
SMITH MEDICAL NURSING CARE
501 E MCCARTY STREET
SANDERSVILLE
GA
31082-2070
WASHINGTON
4
1372163
115369
HERITAGE INN OF SANDERSVILLE HEALTH
652 FERNCREST DRIVE
SANDERSVILLE
GA
31082
WASHINGTON
99911
R
2022-07-01
2023-06-30
2
946
20250
21196
60
21900
8
22
30
118.25
706.53
13
16
29
946
20250
21196
60
21900
8
22
30
2656775
2672524
378346
369679
523265
2656775
173688
500
1111546
852217
5805
2659203
83135
235607
170698
1969780
1969780
4799681
135126
119807
1995825
2216966
2216966
2582715
2582715
4799681
5096602
5474949
5474949
553547
4921402
5329299
-407897
215702
-192195
-192195
472891
70171
1355152
115414
HARBORVIEW HEALTH SYSTEM OF JESUP
1090 W ORANGE STREET
JESUP
GA
31545
WAYNE
99911
R
2022-01-01
2022-12-31
4
7130
19783
4717
31630
90
32850
139
311
150
600
51.29
63.61
52.72
195
232
151
578
7130
19783
4717
31630
90
32850
139
311
150
600
3262869
3815562
1600735
687514
566518
3262869
601828
1340006
139803
663877
2480943
344452
317316
335401
170952
170952
2987296
546883
97094
7495
9399
-1358321
-697450
-697450
3684746
3684746
2987296
8474438
10074755
10074755
1340870
8733885
7468881
1265004
918962
2183966
2183966
2502245
591569
1361499
115503
JESUP HEALTHCARE AND REHAB
3100 SAVANNAH HIGHWAY
JESUP
GA
31545
WAYNE
99911
R
2022-01-01
2022-12-31
4
2163
12594
3138
17895
72
26280
44
57
104
205
49.16
220.95
87.29
72
22
109
203
2163
12594
3138
17895
72
26280
44
57
104
205
2194564
2975753
839734
506563
259328
2194564
507146
-6517
989858
44311
1749452
139966
345119
149535
1898987
250405
177373
111805
539583
1351
540934
1358053
1358053
1898987
3617072
4456806
4456806
-452268
4909074
5170317
-261243
-142211
-403454
-403454
1264397
133104
1377973
115577
ALTAMAHA HEALTHCARE CENTER
1311 W. CHERRY ST
JESUP
GA
31545
WAYNE
99911
R
2022-01-01
2022-12-31
4
2077
15511
1891
19479
62
22630
38
57
46
141
54.66
272.12
138.15
59
20
52
131
2077
15511
1891
19479
62
22630
38
57
46
141
1814391
2659242
2098116
588311
317938
1814391
-80582
357208
18705
3593531
8200
296239
30656
8323
8323
3632510
426556
143681
22824
795929
1388990
330303
330303
1719293
1913217
1913217
3632510
4127901
6226017
6226017
1479178
4746839
4540015
206824
192153
398977
398977
1310864
162790
1361196
115703
GLENWOOD HEALTHCARE
41 N FIFTH ST
GLENWOOD
GA
30445
WHEELER
99911
R
2022-01-01
2022-12-31
4
1339
12265
624
14228
50
18250
14
37
15
66
95.64
331.49
215.58
24
16
18
58
1339
12265
624
14228
50
18250
14
37
15
66
1327661
2592993
1655895
361257
260316
1327661
-39409
136182
44962
2560477
118262
412597
159171
8323
8323
2727971
583941
79938
19617
475392
1158888
274444
274444
1433332
1294639
1294639
2727971
2999295
4655190
4655190
1381392
3273798
3986226
-712428
933976
221548
221548
1033346
140421
1379243
115560
GATEWAY HEALTH & REHAB
3201 WESTMORELAND
CLEVELAND
GA
30528
WHITE
99911
R
2022-01-01
2022-12-31
6
1597
11695
797
14089
60
21900
14
39
5
58
114.07
299.87
242.91
49
24
5
78
1597
11695
797
14089
60
21900
14
39
5
58
1993712
2804553
770825
748422
480379
1993712
501383
-227902
1663457
11780
53098
3932160
12180
49320
33239
20053
3952213
1800394
57671
20031
102411
1980507
1980507
1971706
1971706
3952213
2933333
3704157
3704157
-460450
4164607
4798265
-633658
245460
-388198
-388198
863213
118136
1380019
115559
FRIENDSHIP HEALTH & REHAB
161 FRIENDSHIP ROAD
CLEVELAND
GA
30528
WHITE
99911
R
2022-01-01
2022-12-31
6
2193
12208
448
14849
89
32485
27
60
5
92
81.22
203.47
161.4
55
66
5
126
2193
12208
448
14849
89
32485
27
60
5
92
2164959
2934893
744209
660904
469541
2164959
455003
-124636
1297800
16519
8656400
53600
25196
21154
54947
8711347
1963167
59221
22552
134158
8684322
8684322
27025
27025
8711347
3348056
4092265
4092265
-892988
4985253
5099852
-114599
328885
214286
214286
1152953
157504
1346392
115341
RIDGEWOOD MANOR NURSING HOME
1110 BURLEYSON DRIVE
DALTON
GA
30720
WHITFIELD
19140
U
2021-10-01
2022-09-30
2
1897
21403
2068
25368
102
37230
23
54
6
83
82.48
396.35
305.64
36
32
12
80
1897
21403
2068
25368
102
37230
23
54
6
83
3233930
3937211
951399
699637
819441
3233930
512391
656154
1485736
339083
46112
82809
1187
1936869
1085000
476840
20884418
2348780
3883605
10102397
3686130
3686130
15725396
742608
1730355
128852
2601815
11195024
11195024
13796839
1928557
1928557
15725396
6308963
7260363
7260363
537245
6723118
7171141
-448023
12849
-435174
-640658
1059318
158481
1346393
115403
QUINTON MEMORIAL HEALTH CARE CENTER
1114 BURLEYSON ROAD
DALTON
GA
30720
WHITFIELD
19140
U
2021-10-01
2022-09-30
2
3545
20924
1790
26259
120
43800
117
56
35
208
30.3
373.64
126.25
146
29
35
210
3545
20924
1790
26259
120
43800
117
56
35
208
3796885
4355431
1363952
914482
885126
3796885
443914
656154
1485736
339083
46112
82809
1187
1936869
1085000
476840
20884418
2348780
3883605
10102397
3686130
3686130
15725396
742608
1730355
128851
2601814
11195024
11195024
13796838
1928558
1928558
15725396
6595159
7959110
7959110
914940
7044170
8152316
-1108146
13294
-1094852
-1161054
1914794
124164
1346394
115663
REGENCY PARK HEALTH & REHABILITATION
1110 BURLEYSON DRIVE
DALTON
GA
30720
WHITFIELD
19140
U
2021-10-01
2022-09-30
2
5324
19453
2769
27546
100
36500
155
65
60
280
34.35
299.28
98.38
176
41
63
280
5324
19453
2769
27546
100
36500
155
65
60
280
4891220
4629894
1989203
1238628
993608
4891220
351403
656154
1485736
339083
46112
82809
1187
1936869
1085000
476840
20884418
2348780
3883605
10102397
3686129
3686129
15725395
742608
1730355
128851
2601814
11195027
11195027
13796841
1928554
1928554
15725395
8938155
10927359
10927359
1716316
9211043
9521114
-310071
14169
-295902
-397830
2886968
132514
1348177
115374
WOOD DALE HEALTH CARE CENTER
1102 BURLEYSON DRIVE
DALTON
GA
30720
WHITFIELD
19140
U
2021-10-01
2022-09-30
2
1248
15285
1706
18239
82
29930
34
38
14
86
36.71
402.24
212.08
37
32
13
82
1248
15285
1706
18239
82
29930
34
38
14
86
2617445
2764032
539899
443141
613625
2617445
98560
656154
1485736
339083
46112
82809
1187
1936869
1085000
476840
20884418
2348780
3883605
10102397
3686130
3686130
15725396
742608
1730355
128851
2601814
11208817
11208817
13810631
1914765
1914765
15725396
4579793
5099899
5099899
950670
4149229
5381477
-1232248
9238
-1223010
-1363964
675254
95840
1360790
115733
GLEN EAGLE HEALTHCARE & REHAB
206 MAIN ST E
ABBEVILLE
GA
31001
WILCOX
99911
R
2022-01-01
2022-12-31
6
3357
18861
350
22568
101
36865
31
183
26
240
108.29
103.07
94.03
69
151
22
242
3357
18861
350
22568
101
36865
31
183
26
240
2798121
2862217
2733859
535839
380513
2798121
3440669
924443
4264
4461998
125838
289625
296743
4758741
130338
92019
-7227
1647582
1862712
1862712
2896029
2896029
4758741
5212512
7946371
7946371
1651205
6295166
5764008
531158
578075
1109233
1109233
1682753
474842
1372972
115325
PRUITTHEALTH – WASHINGTON LLC
112 HOSPITAL DRIVE
WASHINGTON
GA
30673
WILKES
99911
R
2022-07-01
2023-06-30
6
17
14446
1579
16042
47
17155
11
21
32
1313.27
501.31
1
11
14
26
17
14446
1579
16042
47
17155
11
21
32
1786389
2512353
452550
375550
237742
1786389
27796
141462
24217
4414
-4681311
50993
256873
229414
174805
8585
8585
-4497921
159183
203284
234
-2937
359764
359764
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4409283
4861832
4861832
1173986
3687846
4298742
-610896
175045
-435851
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8934
1373617
115455
PRUITTHEALTH – TOOMSBORO LLC
HIGHWAY 112
TOOMSBORO
GA
31090
WILKINSON
99911
R
2022-07-01
2023-06-30
6
709
12529
5890
19128
62
22630
17
23
111
151
41.71
544.74
126.68
24
4
104
132
709
12529
5890
19128
62
22630
17
23
111
151
2203891
3253040
826245
748545
333746
2203891
51662
857865
289581
4414
-1423898
59215
597829
312481
248286
354187
9182
9182
-1060529
199182
240335
-343
13843
453017
453017
-1513546
-1513546
-1060529
5078970
5905215
5905215
1016014
4889201
5456931
-567730
101367
-466363
-466363
379895
2578
1369381
115629
PRUITTHEALTH – SYLVESTER LLC
104 MONK STREET
SYLVESTER
GA
31791
WORTH
10500
U
2022-07-01
2023-06-30
6
1015
28576
4353
33944
117
42705
22
42
75
139
46.14
680.38
244.2
30
27
74
131
1015
28576
4353
33944
117
42705
22
42
75
139
3859147
5618044
1014410
967603
523549
3859147
67371
532556
863383
358623
6566
-3459227
22800
146657
312137
392421
288582
288582
-2778224
317612
365819
-167
119376
22377
825017
606827
240026
846853
1671870
-4450094
-4450094
-2778224
7965413
8979823
8979823
568088
8411735
9477191
-1065456
442043
-623413
-623413
556901
56464
…
