Liberty Commons Nsg And Rehab Ctr Of Halifax Cty - Weldon Nursing Home
General Information
UPDATEFederal Provider Number
345309
Provider Name
LIBERTY COMMONS NSG AND REHAB CTR OF HALIFAX CTY
Provider Address
101 CAROLINE AVENUE
WELDON, NC 27890
WELDON, NC 27890
Provider Phone Number
(252) 536-4817
Provider SSA County
410
Provider County Name
Halifax
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
47
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
1989-09-25
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
1.89894
Reported LPN Staffing Hours per Resident per Day
0.73191
Reported RN Staffing Hours per Resident per Day
0.54574
Reported Licensed Staffing Hours per Resident per Day
1.27766
Reported Total Nurse Staffing Hours per Resident per Day
3.17659
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14255
Expected CNA Staffing Hours per Resident per Day
2.62099
Expected LPN Staffing Hours per Resident per Day
0.75678
Expected RN Staffing Hours per Resident per Day
1.27023
Expected Total Nurse Staffing Hours per Resident per Day
4.64800
Adjusted CNA Staffing Hours per Resident per Day
1.77774
Adjusted LPN Staffing Hours per Resident per Day
0.80273
Adjusted RN Staffing Hours per Resident per Day
0.32103
Adjusted Total Nurse Staffing Hours per Resident per Day
2.75485
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-07-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-05-31
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
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
36
Cycle 3 Total Health Score
108
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
Number of Fines
1
Total Amount of Fines in Dollars
1105
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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