Inn At Quail Haven Village - Pinehurst Nursing Home
General Information
UPDATEFederal Provider Number
345518
Provider Name
INN AT QUAIL HAVEN VILLAGE
Provider Address
155 BLAKE BOULEVARD
PINEHURST, NC 28374
PINEHURST, NC 28374
Provider Phone Number
(910) 295-2294
Provider SSA County
620
Provider County Name
Moore
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY HEALTHCARE GROUP LLC
Date First Approved to Provide Medicare and Medicaid services
2002-09-12
Continuing Care Retirement Community
Y
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
4
QM Rating Footnote
Staffing Rating
2
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
2.43750
Reported LPN Staffing Hours per Resident per Day
1.21125
Reported RN Staffing Hours per Resident per Day
0.37875
Reported Licensed Staffing Hours per Resident per Day
1.59000
Reported Total Nurse Staffing Hours per Resident per Day
4.02750
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17000
Expected CNA Staffing Hours per Resident per Day
2.25364
Expected LPN Staffing Hours per Resident per Day
0.60248
Expected RN Staffing Hours per Resident per Day
1.01423
Expected Total Nurse Staffing Hours per Resident per Day
3.87035
Adjusted CNA Staffing Hours per Resident per Day
2.65388
Adjusted LPN Staffing Hours per Resident per Day
1.66867
Adjusted RN Staffing Hours per Resident per Day
0.27903
Adjusted Total Nurse Staffing Hours per Resident per Day
4.19457
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-10-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
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
24
Cycle 2 Standard Health Survey Date
2013-07-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
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
16
Cycle 3 Standard Health Survey Date
2012-08-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
28.66700
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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