Hiram W Davis Medical Ctr - Petersburg Nursing Home
General Information
UPDATEFederal Provider Number
495113
Provider Name
HIRAM W DAVIS MEDICAL CTR
Provider Address
26317 WEST WASHINGTON STREET
PETERSBURG, VA 23803
PETERSBURG, VA 23803
Provider Phone Number
(804) 524-7420
Provider SSA County
701
Provider County Name
Petersburg City
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
83
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COMMONWEALTH OF VIRGINIA HIRAM W DAVIS MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
1978-04-16
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.47000
Reported LPN Staffing Hours per Resident per Day
3.61154
Reported RN Staffing Hours per Resident per Day
1.42385
Reported Licensed Staffing Hours per Resident per Day
5.03538
Reported Total Nurse Staffing Hours per Resident per Day
8.50539
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11846
Expected CNA Staffing Hours per Resident per Day
2.82064
Expected LPN Staffing Hours per Resident per Day
0.92252
Expected RN Staffing Hours per Resident per Day
1.09184
Expected Total Nurse Staffing Hours per Resident per Day
4.83500
Adjusted CNA Staffing Hours per Resident per Day
3.01858
Adjusted LPN Staffing Hours per Resident per Day
3.24934
Adjusted RN Staffing Hours per Resident per Day
0.97441
Adjusted Total Nurse Staffing Hours per Resident per Day
7.09088
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
116
Cycle 1 Standard Survey Health Date
2014-10-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
116
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-09-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
76.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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