Exalted Health & Rehab Of Iva - Iva Nursing Home
General Information
UPDATEFederal Provider Number
425317
Provider Name
EXALTED HEALTH & REHAB OF IVA
Provider Address
406 WEST BROAD STREET
IVA, SC 29655
IVA, SC 29655
Provider Phone Number
(864) 348-7433
Provider SSA County
30
Provider County Name
Anderson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NEW EXALTED HEALTH & REHAB OF IVA LLC
Date First Approved to Provide Medicare and Medicaid services
1991-10-09
Continuing Care Retirement Community
N
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.31698
Reported LPN Staffing Hours per Resident per Day
0.99906
Reported RN Staffing Hours per Resident per Day
0.93868
Reported Licensed Staffing Hours per Resident per Day
1.93774
Reported Total Nurse Staffing Hours per Resident per Day
4.25472
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11981
Expected CNA Staffing Hours per Resident per Day
2.70169
Expected LPN Staffing Hours per Resident per Day
0.66402
Expected RN Staffing Hours per Resident per Day
1.11563
Expected Total Nurse Staffing Hours per Resident per Day
4.48134
Adjusted CNA Staffing Hours per Resident per Day
2.10430
Adjusted LPN Staffing Hours per Resident per Day
1.24878
Adjusted RN Staffing Hours per Resident per Day
0.62869
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82706
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-10-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
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
2012-10-23
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
56.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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