Magnolia Manor - Greenville - Greenville Nursing Home
General Information
UPDATEFederal Provider Number
425090
Provider Name
MAGNOLIA MANOR - GREENVILLE
Provider Address
411 ANSEL ST
GREENVILLE, SC 29601
GREENVILLE, SC 29601
Provider Phone Number
(864) 232-5368
Provider SSA County
220
Provider County Name
Greenville
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THI OF SOUTH CAROLINA AT GREENVILLE, LLC
Date First Approved to Provide Medicare and Medicaid services
1972-09-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
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
2.37989
Reported LPN Staffing Hours per Resident per Day
0.97283
Reported RN Staffing Hours per Resident per Day
0.51087
Reported Licensed Staffing Hours per Resident per Day
1.48370
Reported Total Nurse Staffing Hours per Resident per Day
3.86359
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01250
Expected CNA Staffing Hours per Resident per Day
2.38277
Expected LPN Staffing Hours per Resident per Day
0.60684
Expected RN Staffing Hours per Resident per Day
0.93084
Expected Total Nurse Staffing Hours per Resident per Day
3.92046
Adjusted CNA Staffing Hours per Resident per Day
2.45073
Adjusted LPN Staffing Hours per Resident per Day
1.33057
Adjusted RN Staffing Hours per Resident per Day
0.41008
Adjusted Total Nurse Staffing Hours per Resident per Day
3.97243
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-06-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2012-11-28
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
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2011-08-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
1
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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