Chowan River Nursing And Rehabilitation Center - Edenton Nursing Home
General Information
UPDATEFederal Provider Number
345164
Provider Name
CHOWAN RIVER NURSING AND REHABILITATION CENTER
Provider Address
1341 PARADISE ROAD P O BOX 566
EDENTON, NC 27932
EDENTON, NC 27932
Provider Phone Number
(252) 482-7481
Provider SSA County
200
Provider County Name
Chowan
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
130
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TAR RIVER LTC GROUP, LLC
Date First Approved to Provide Medicare and Medicaid services
1977-05-01
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
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
2.26744
Reported LPN Staffing Hours per Resident per Day
0.71802
Reported RN Staffing Hours per Resident per Day
0.74360
Reported Licensed Staffing Hours per Resident per Day
1.46163
Reported Total Nurse Staffing Hours per Resident per Day
3.72906
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06628
Expected CNA Staffing Hours per Resident per Day
2.47058
Expected LPN Staffing Hours per Resident per Day
0.74481
Expected RN Staffing Hours per Resident per Day
1.26070
Expected Total Nurse Staffing Hours per Resident per Day
4.47610
Adjusted CNA Staffing Hours per Resident per Day
2.25195
Adjusted LPN Staffing Hours per Resident per Day
0.80014
Adjusted RN Staffing Hours per Resident per Day
0.44072
Adjusted Total Nurse Staffing Hours per Resident per Day
3.35817
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
16
Cycle 1 Standard Survey Health Date
2015-03-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-02-06
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
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
2013-01-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
8.66700
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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