Clear Creek Nursing & Rehabilitation Center - Mint Hill Nursing Home
General Information
UPDATEFederal Provider Number
345562
Provider Name
CLEAR CREEK NURSING & REHABILITATION CENTER
Provider Address
10506 CLEAR CREEK COMMERCE DRIVE
MINT HILL, NC 28227
MINT HILL, NC 28227
Provider Phone Number
(704) 545-2377
Provider SSA County
590
Provider County Name
Mecklenburg
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
76
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SPRUCE LTC GROUP, LLC
Date First Approved to Provide Medicare and Medicaid services
2013-11-07
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.65066
Reported LPN Staffing Hours per Resident per Day
0.82434
Reported RN Staffing Hours per Resident per Day
0.70461
Reported Licensed Staffing Hours per Resident per Day
1.52895
Reported Total Nurse Staffing Hours per Resident per Day
4.17961
Reported Physical Therapist Staffing Hours per Resident Per Day
0.53750
Expected CNA Staffing Hours per Resident per Day
2.43933
Expected LPN Staffing Hours per Resident per Day
0.70610
Expected RN Staffing Hours per Resident per Day
1.39945
Expected Total Nurse Staffing Hours per Resident per Day
4.54488
Adjusted CNA Staffing Hours per Resident per Day
2.66628
Adjusted LPN Staffing Hours per Resident per Day
0.96899
Adjusted RN Staffing Hours per Resident per Day
0.37621
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70694
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-03-19
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
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
2013-11-07
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
16.80000
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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