Calhoun Convalescent Center - Saint Matthews Nursing Home

General Information

UPDATE
Federal Provider Number
425170
Provider Name
CALHOUN CONVALESCENT CENTER
Provider Address
601 DANTZLER STREET
SAINT MATTHEWS, SC 29135
Provider Phone Number
8036557101
Provider SSA County
80
Provider County Name
Calhoun
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
114
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CALHOUN CONVALESCENT CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1989-01-26
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.62105
Reported LPN Staffing Hours per Resident per Day
0.87412
Reported RN Staffing Hours per Resident per Day
0.56667
Reported Licensed Staffing Hours per Resident per Day
1.44079
Reported Total Nurse Staffing Hours per Resident per Day
4.06184
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03246
Expected CNA Staffing Hours per Resident per Day
2.31440
Expected LPN Staffing Hours per Resident per Day
0.65493
Expected RN Staffing Hours per Resident per Day
1.00138
Expected Total Nurse Staffing Hours per Resident per Day
3.97071
Adjusted CNA Staffing Hours per Resident per Day
2.77881
Adjusted LPN Staffing Hours per Resident per Day
1.10778
Adjusted RN Staffing Hours per Resident per Day
0.42283
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12341
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-12-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-03-27
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-04-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
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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