Jackie Withrow Hospital - Beckley Nursing Home
General Information
UPDATEFederal Provider Number
510000000000000000000000000000
Provider Name
JACKIE WITHROW HOSPITAL
Provider Address
105 SOUTH EISENHOWER DRIVE
BECKLEY, WV 25801
BECKLEY, WV 25801
Provider Phone Number
(304) 256-6600
Provider SSA County
400
Provider County Name
Raleigh
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
199
Number of Residents in Certified Beds
88
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1981-09-29
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
1
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.84432
Reported LPN Staffing Hours per Resident per Day
1.27273
Reported RN Staffing Hours per Resident per Day
0.32500
Reported Licensed Staffing Hours per Resident per Day
1.59773
Reported Total Nurse Staffing Hours per Resident per Day
2.44205
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00341
Expected CNA Staffing Hours per Resident per Day
2.06278
Expected LPN Staffing Hours per Resident per Day
0.55435
Expected RN Staffing Hours per Resident per Day
0.77926
Expected Total Nurse Staffing Hours per Resident per Day
3.39638
Adjusted CNA Staffing Hours per Resident per Day
1.00433
Adjusted LPN Staffing Hours per Resident per Day
1.90561
Adjusted RN Staffing Hours per Resident per Day
0.31163
Adjusted Total Nurse Staffing Hours per Resident per Day
2.89828
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-06-25
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
29
Cycle 3 Number of Standard Health Deficiencies
20
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
160
Cycle 3 Standard Health Survey Date
2011-12-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
160
Total Weighted Health Survey Score
74.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
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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