Libertywood Nursing Center - Thomasville Nursing Home
General Information
UPDATEFederal Provider Number
345520
Provider Name
LIBERTYWOOD NURSING CENTER
Provider Address
1028 BLAIR STREET
THOMASVILLE, NC 27360
THOMASVILLE, NC 27360
Provider Phone Number
(336) 472-7771
Provider SSA County
280
Provider County Name
Davidson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
90
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTYWOOD NURSING CENTER INC
Date First Approved to Provide Medicare and Medicaid services
2002-10-31
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
3
QM Rating Footnote
Staffing Rating
4
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
2.47667
Reported LPN Staffing Hours per Resident per Day
0.57167
Reported RN Staffing Hours per Resident per Day
0.94722
Reported Licensed Staffing Hours per Resident per Day
1.51889
Reported Total Nurse Staffing Hours per Resident per Day
3.99556
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06333
Expected CNA Staffing Hours per Resident per Day
2.46226
Expected LPN Staffing Hours per Resident per Day
0.65513
Expected RN Staffing Hours per Resident per Day
0.99039
Expected Total Nurse Staffing Hours per Resident per Day
4.10777
Adjusted CNA Staffing Hours per Resident per Day
2.46806
Adjusted LPN Staffing Hours per Resident per Day
0.72427
Adjusted RN Staffing Hours per Resident per Day
0.71463
Adjusted Total Nurse Staffing Hours per Resident per Day
3.92079
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-12-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
71.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
12
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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