Riverside Conval Center-mathew - Mathews Nursing Home
General Information
UPDATEFederal Provider Number
490000000000000000000000000000
Provider Name
RIVERSIDE CONVAL CENTER-MATHEW
Provider Address
PO BOX 370
MATHEWS, VA 23109
MATHEWS, VA 23109
Provider Phone Number
(804) 725-9443
Provider SSA County
570
Provider County Name
Mathews
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
58
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1982-07-06
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.28966
Reported LPN Staffing Hours per Resident per Day
0.54483
Reported RN Staffing Hours per Resident per Day
0.72414
Reported Licensed Staffing Hours per Resident per Day
1.26897
Reported Total Nurse Staffing Hours per Resident per Day
3.55863
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04397
Expected CNA Staffing Hours per Resident per Day
2.52720
Expected LPN Staffing Hours per Resident per Day
0.66716
Expected RN Staffing Hours per Resident per Day
0.93739
Expected Total Nurse Staffing Hours per Resident per Day
4.13175
Adjusted CNA Staffing Hours per Resident per Day
2.22307
Adjusted LPN Staffing Hours per Resident per Day
0.67781
Adjusted RN Staffing Hours per Resident per Day
0.57722
Adjusted Total Nurse Staffing Hours per Resident per Day
3.47177
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-04-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-04-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-02-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
19.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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