Carolina Care Center - Cherryville Nursing Home
General Information
UPDATEFederal Provider Number
345255
Provider Name
CAROLINA CARE CENTER
Provider Address
111 HARRILSON STREET
CHERRYVILLE, NC 28021
CHERRYVILLE, NC 28021
Provider Phone Number
(704) 435-4161
Provider SSA County
350
Provider County Name
Gaston
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
107
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CAROLINA CARE CENTER OF CHERRYVILLE, INC.
Date First Approved to Provide Medicare and Medicaid services
1986-08-19
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.42582
Reported LPN Staffing Hours per Resident per Day
0.94176
Reported RN Staffing Hours per Resident per Day
0.85659
Reported Licensed Staffing Hours per Resident per Day
1.79835
Reported Total Nurse Staffing Hours per Resident per Day
4.22417
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05659
Expected CNA Staffing Hours per Resident per Day
2.37593
Expected LPN Staffing Hours per Resident per Day
0.60105
Expected RN Staffing Hours per Resident per Day
1.00832
Expected Total Nurse Staffing Hours per Resident per Day
3.98530
Adjusted CNA Staffing Hours per Resident per Day
2.50523
Adjusted LPN Staffing Hours per Resident per Day
1.30050
Adjusted RN Staffing Hours per Resident per Day
0.63476
Adjusted Total Nurse Staffing Hours per Resident per Day
4.27251
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-03-12
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
12
Cycle 3 Standard Health Survey Date
2012-08-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
17.33300
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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