Liberty Commons Nsg & Reh John - Benson Nursing Home
General Information
UPDATEFederal Provider Number
345519
Provider Name
LIBERTY COMMONS NSG & REH JOHN
Provider Address
2315 HIGHWAY 242 NORTH
BENSON, NC 27504
BENSON, NC 27504
Provider Phone Number
(919) 207-1717
Provider SSA County
500
Provider County Name
Johnston
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
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
2002-09-25
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
2.07474
Reported LPN Staffing Hours per Resident per Day
0.90579
Reported RN Staffing Hours per Resident per Day
0.38421
Reported Licensed Staffing Hours per Resident per Day
1.29000
Reported Total Nurse Staffing Hours per Resident per Day
3.36474
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09789
Expected CNA Staffing Hours per Resident per Day
2.50574
Expected LPN Staffing Hours per Resident per Day
0.65536
Expected RN Staffing Hours per Resident per Day
1.01337
Expected Total Nurse Staffing Hours per Resident per Day
4.17447
Adjusted CNA Staffing Hours per Resident per Day
2.03165
Adjusted LPN Staffing Hours per Resident per Day
1.14716
Adjusted RN Staffing Hours per Resident per Day
0.28329
Adjusted Total Nurse Staffing Hours per Resident per Day
3.24902
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-09-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-07-25
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-05-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
38.00000
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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