Liberty Commons N&r Ctr Of Columbus Cty - Whiteville Nursing Home
General Information
UPDATEFederal Provider Number
345207
Provider Name
LIBERTY COMMONS N&R CTR OF COLUMBUS CTY
Provider Address
1402 PINCKNEY STREET
WHITEVILLE, NC 28472
WHITEVILLE, NC 28472
Provider Phone Number
(910) 642-4245
Provider SSA County
230
Provider County Name
Columbus
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
107
Number of Residents in Certified Beds
95
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
1981-10-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.51947
Reported LPN Staffing Hours per Resident per Day
0.97474
Reported RN Staffing Hours per Resident per Day
0.54895
Reported Licensed Staffing Hours per Resident per Day
1.52368
Reported Total Nurse Staffing Hours per Resident per Day
4.04316
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08053
Expected CNA Staffing Hours per Resident per Day
2.62892
Expected LPN Staffing Hours per Resident per Day
0.65982
Expected RN Staffing Hours per Resident per Day
1.07112
Expected Total Nurse Staffing Hours per Resident per Day
4.35985
Adjusted CNA Staffing Hours per Resident per Day
2.35155
Adjusted LPN Staffing Hours per Resident per Day
1.22615
Adjusted RN Staffing Hours per Resident per Day
0.38294
Adjusted Total Nurse Staffing Hours per Resident per Day
3.73810
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-09-24
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-10-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
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
2012-11-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
9.33300
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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