Evergreen Health And Rehab - Winchester Nursing Home
General Information
UPDATEFederal Provider Number
495142
Provider Name
EVERGREEN HEALTH AND REHAB
Provider Address
380 MILLWOOD AVENUE
WINCHESTER, VA 22601
WINCHESTER, VA 22601
Provider Phone Number
(540) 667-7010
Provider SSA County
962
Provider County Name
Winchester City
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
176
Number of Residents in Certified Beds
145
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PINNACLE SERVICES WINCHESTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1984-07-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
2.07966
Reported LPN Staffing Hours per Resident per Day
0.78069
Reported RN Staffing Hours per Resident per Day
0.56931
Reported Licensed Staffing Hours per Resident per Day
1.35000
Reported Total Nurse Staffing Hours per Resident per Day
3.42966
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03345
Expected CNA Staffing Hours per Resident per Day
2.56728
Expected LPN Staffing Hours per Resident per Day
0.69500
Expected RN Staffing Hours per Resident per Day
1.11339
Expected Total Nurse Staffing Hours per Resident per Day
4.37566
Adjusted CNA Staffing Hours per Resident per Day
1.98766
Adjusted LPN Staffing Hours per Resident per Day
0.93233
Adjusted RN Staffing Hours per Resident per Day
0.38207
Adjusted Total Nurse Staffing Hours per Resident per Day
3.15943
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-03-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
100
Cycle 2 Standard Health Survey Date
2013-03-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
100
Cycle 3 Total Number of Health Deficiencies
24
Cycle 3 Number of Standard Health Deficiencies
21
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
152
Cycle 3 Standard Health Survey Date
2012-02-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
152
Total Weighted Health Survey Score
88.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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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