Creekside Care & Rehabilitation Center - Ahoskie Nursing Home
General Information
UPDATEFederal Provider Number
345359
Provider Name
CREEKSIDE CARE & REHABILITATION CENTER
Provider Address
604 STOKES STREET EAST
AHOSKIE, NC 27910
AHOSKIE, NC 27910
Provider Phone Number
2523322126
Provider SSA County
450
Provider County Name
Hertford
Ownership Type
For profit - Corporation
Number of Certified Beds
151
Number of Residents in Certified Beds
133
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP AHOSKIE, LLC
Date First Approved to Provide Medicare and Medicaid services
1991-04-04
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
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
1.90489
Reported LPN Staffing Hours per Resident per Day
0.80075
Reported RN Staffing Hours per Resident per Day
0.62707
Reported Licensed Staffing Hours per Resident per Day
1.42782
Reported Total Nurse Staffing Hours per Resident per Day
3.33271
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07895
Expected CNA Staffing Hours per Resident per Day
2.45795
Expected LPN Staffing Hours per Resident per Day
0.65238
Expected RN Staffing Hours per Resident per Day
1.14937
Expected Total Nurse Staffing Hours per Resident per Day
4.25969
Adjusted CNA Staffing Hours per Resident per Day
1.90160
Adjusted LPN Staffing Hours per Resident per Day
1.01877
Adjusted RN Staffing Hours per Resident per Day
0.40766
Adjusted Total Nurse Staffing Hours per Resident per Day
3.15371
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-12-18
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-11-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
14.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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