John Manchin Sr Health Care Center - Fairmont Nursing Home
General Information
UPDATEFederal Provider Number
515075
Provider Name
JOHN MANCHIN SR HEALTH CARE CENTER
Provider Address
401 GUFFEY STREET
FAIRMONT, WV 26554
FAIRMONT, WV 26554
Provider Phone Number
(304) 363-2500
Provider SSA County
240
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
41
Number of Residents in Certified Beds
36
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1983-04-13
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
2.38056
Reported LPN Staffing Hours per Resident per Day
1.26944
Reported RN Staffing Hours per Resident per Day
1.26944
Reported Licensed Staffing Hours per Resident per Day
2.53889
Reported Total Nurse Staffing Hours per Resident per Day
4.91944
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.53028
Expected LPN Staffing Hours per Resident per Day
0.61676
Expected RN Staffing Hours per Resident per Day
0.82750
Expected Total Nurse Staffing Hours per Resident per Day
3.97454
Adjusted CNA Staffing Hours per Resident per Day
2.30851
Adjusted LPN Staffing Hours per Resident per Day
1.70834
Adjusted RN Staffing Hours per Resident per Day
1.14625
Adjusted Total Nurse Staffing Hours per Resident per Day
4.98920
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
22
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
124
Cycle 1 Standard Survey Health Date
2014-07-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
124
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
32
Cycle 2 Standard Health Survey Date
2013-01-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2011-06-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
84.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
74588
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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