Heritage Hall Clintwood - Clintwood Nursing Home
General Information
UPDATEFederal Provider Number
495320
Provider Name
HERITAGE HALL CLINTWOOD
Provider Address
1225 CLINTWOOD MAIN STREET, ROUTE 607 PO BOX 909
CLINTWOOD, VA 24228
CLINTWOOD, VA 24228
Provider Phone Number
(276) 926-4693
Provider SSA County
250
Provider County Name
Dickenson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
90
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICAN HEALTHCARE LLC
Date First Approved to Provide Medicare and Medicaid services
1997-06-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.72167
Reported LPN Staffing Hours per Resident per Day
0.73556
Reported RN Staffing Hours per Resident per Day
0.36889
Reported Licensed Staffing Hours per Resident per Day
1.10444
Reported Total Nurse Staffing Hours per Resident per Day
2.82612
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01333
Expected CNA Staffing Hours per Resident per Day
2.59104
Expected LPN Staffing Hours per Resident per Day
0.74588
Expected RN Staffing Hours per Resident per Day
1.10054
Expected Total Nurse Staffing Hours per Resident per Day
4.43746
Adjusted CNA Staffing Hours per Resident per Day
1.63041
Adjusted LPN Staffing Hours per Resident per Day
0.81852
Adjusted RN Staffing Hours per Resident per Day
0.25045
Adjusted Total Nurse Staffing Hours per Resident per Day
2.56719
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
20
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2014-02-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
39.33300
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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