Countrywood Nursing Center, Llc - Hopkins Nursing Home

General Information

UPDATE
Federal Provider Number
425370
Provider Name
COUNTRYWOOD NURSING CENTER, LLC
Provider Address
1645 RIDGE ROAD
HOPKINS, SC 29061
Provider Phone Number
8037763873
Provider SSA County
390
Provider County Name
Richland
Ownership Type
For profit - Corporation
Number of Certified Beds
38
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRYWOOD NURSING CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
2000-05-17
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
2
Health Inspection Rating Footnote
QM Rating
5
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
2.51129
Reported LPN Staffing Hours per Resident per Day
1.26774
Reported RN Staffing Hours per Resident per Day
0.44194
Reported Licensed Staffing Hours per Resident per Day
1.70968
Reported Total Nurse Staffing Hours per Resident per Day
4.22097
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00968
Expected CNA Staffing Hours per Resident per Day
2.65434
Expected LPN Staffing Hours per Resident per Day
0.60948
Expected RN Staffing Hours per Resident per Day
0.89369
Expected Total Nurse Staffing Hours per Resident per Day
4.15752
Adjusted CNA Staffing Hours per Resident per Day
2.32146
Adjusted LPN Staffing Hours per Resident per Day
1.72642
Adjusted RN Staffing Hours per Resident per Day
0.36950
Adjusted Total Nurse Staffing Hours per Resident per Day
4.09242
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-04-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-02-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
56.00000
Number of Facility Reported Incidents
1
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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