Autumn Care Of Fayetteville - Fayetteville Nursing Home
General Information
UPDATEFederal Provider Number
345553
Provider Name
AUTUMN CARE OF FAYETTEVILLE
Provider Address
1401 71ST SCHOOL ROAD
FAYETTEVILLE, NC 28314
FAYETTEVILLE, NC 28314
Provider Phone Number
(910) 867-4960
Provider SSA County
250
Provider County Name
Cumberland
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
89
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AUTUMN CORPORATION
Date First Approved to Provide Medicare and Medicaid services
2011-03-24
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.56011
Reported LPN Staffing Hours per Resident per Day
1.17809
Reported RN Staffing Hours per Resident per Day
0.41067
Reported Licensed Staffing Hours per Resident per Day
1.58876
Reported Total Nurse Staffing Hours per Resident per Day
4.14887
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13708
Expected CNA Staffing Hours per Resident per Day
2.51808
Expected LPN Staffing Hours per Resident per Day
0.69767
Expected RN Staffing Hours per Resident per Day
1.17874
Expected Total Nurse Staffing Hours per Resident per Day
4.39449
Adjusted CNA Staffing Hours per Resident per Day
2.49466
Adjusted LPN Staffing Hours per Resident per Day
1.40154
Adjusted RN Staffing Hours per Resident per Day
0.26032
Adjusted Total Nurse Staffing Hours per Resident per Day
3.80561
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-12-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
87
Cycle 2 Standard Health Survey Date
2014-01-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
87
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-10-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
79.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
60840
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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