Canterbury Center - Shepherdstown Nursing Home
General Information
UPDATEFederal Provider Number
515179
Provider Name
CANTERBURY CENTER
Provider Address
80 MADDEX DRIVE
SHEPHERDSTOWN, WV 25443
SHEPHERDSTOWN, WV 25443
Provider Phone Number
(304) 876-9422
Provider SSA County
180
Provider County Name
Jefferson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
62
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
80 MADDEX DRIVE OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
2002-07-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.36842
Reported LPN Staffing Hours per Resident per Day
0.66667
Reported RN Staffing Hours per Resident per Day
0.76140
Reported Licensed Staffing Hours per Resident per Day
1.42807
Reported Total Nurse Staffing Hours per Resident per Day
3.79649
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04737
Expected CNA Staffing Hours per Resident per Day
2.73950
Expected LPN Staffing Hours per Resident per Day
0.73878
Expected RN Staffing Hours per Resident per Day
1.23427
Expected Total Nurse Staffing Hours per Resident per Day
4.71254
Adjusted CNA Staffing Hours per Resident per Day
2.12133
Adjusted LPN Staffing Hours per Resident per Day
0.74899
Adjusted RN Staffing Hours per Resident per Day
0.46093
Adjusted Total Nurse Staffing Hours per Resident per Day
3.24735
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-09-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
112
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-04-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
74.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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