Golden Age - Inman - Inman Nursing Home

General Information

UPDATE
Federal Provider Number
425316
Provider Name
GOLDEN AGE - INMAN
Provider Address
82 N MAIN STREET
INMAN, SC 29349
Provider Phone Number
(864) 472-6636
Provider SSA County
410
Provider County Name
Spartanburg
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
26
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INMAN GOLDEN AGE OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1991-10-11
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
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.17885
Reported LPN Staffing Hours per Resident per Day
0.61923
Reported RN Staffing Hours per Resident per Day
0.63654
Reported Licensed Staffing Hours per Resident per Day
1.25577
Reported Total Nurse Staffing Hours per Resident per Day
3.43462
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03269
Expected CNA Staffing Hours per Resident per Day
2.52877
Expected LPN Staffing Hours per Resident per Day
0.62702
Expected RN Staffing Hours per Resident per Day
0.97209
Expected Total Nurse Staffing Hours per Resident per Day
4.12788
Adjusted CNA Staffing Hours per Resident per Day
2.11417
Adjusted LPN Staffing Hours per Resident per Day
0.81969
Adjusted RN Staffing Hours per Resident per Day
0.48928
Adjusted Total Nurse Staffing Hours per Resident per Day
3.35393
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2015-03-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-06-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-01-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
51.33300
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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