Covenant Place Nursing Center - Sumter Nursing Home
General Information
UPDATEFederal Provider Number
425402
Provider Name
COVENANT PLACE NURSING CENTER
Provider Address
2825 CARTER ROAD
SUMTER, SC 29150
SUMTER, SC 29150
Provider Phone Number
(803) 469-7007
Provider SSA County
420
Provider County Name
Sumter
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
28
Number of Residents in Certified Beds
22
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
COVENANT PLACE OF SUMTER, INC
Date First Approved to Provide Medicare and Medicaid services
2011-09-09
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.70000
Reported LPN Staffing Hours per Resident per Day
1.32500
Reported RN Staffing Hours per Resident per Day
1.58409
Reported Licensed Staffing Hours per Resident per Day
2.90909
Reported Total Nurse Staffing Hours per Resident per Day
5.60909
Reported Physical Therapist Staffing Hours per Resident Per Day
0.38864
Expected CNA Staffing Hours per Resident per Day
2.37839
Expected LPN Staffing Hours per Resident per Day
0.75205
Expected RN Staffing Hours per Resident per Day
1.39854
Expected Total Nurse Staffing Hours per Resident per Day
4.52898
Adjusted CNA Staffing Hours per Resident per Day
2.78549
Adjusted LPN Staffing Hours per Resident per Day
1.46234
Adjusted RN Staffing Hours per Resident per Day
0.84633
Adjusted Total Nurse Staffing Hours per Resident per Day
4.99222
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
48
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-01-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
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
28
Total Weighted Health Survey Score
31.33300
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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