Magnolia Manor - Inman - Inman Nursing Home
General Information
UPDATEFederal Provider Number
425032
Provider Name
MAGNOLIA MANOR - INMAN
Provider Address
63 BLACKSTOCK ROAD
INMAN, SC 29349
INMAN, SC 29349
Provider Phone Number
(864) 472-9055
Provider SSA County
410
Provider County Name
Spartanburg
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
176
Number of Residents in Certified Beds
159
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THI OF SOUTH CAROLINA AT MAGNOLIA MANORINMAN, LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
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
2.11415
Reported LPN Staffing Hours per Resident per Day
1.13270
Reported RN Staffing Hours per Resident per Day
0.56006
Reported Licensed Staffing Hours per Resident per Day
1.69277
Reported Total Nurse Staffing Hours per Resident per Day
3.80691
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03742
Expected CNA Staffing Hours per Resident per Day
2.58867
Expected LPN Staffing Hours per Resident per Day
0.62443
Expected RN Staffing Hours per Resident per Day
0.94939
Expected Total Nurse Staffing Hours per Resident per Day
4.16249
Adjusted CNA Staffing Hours per Resident per Day
2.00392
Adjusted LPN Staffing Hours per Resident per Day
1.50561
Adjusted RN Staffing Hours per Resident per Day
0.44078
Adjusted Total Nurse Staffing Hours per Resident per Day
3.68656
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
108
Cycle 1 Standard Survey Health Date
2014-02-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
100
Cycle 2 Standard Health Survey Date
2012-10-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
100
Cycle 3 Total Number of Health Deficiencies
20
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
136
Cycle 3 Standard Health Survey Date
2011-08-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
136
Total Weighted Health Survey Score
110.00000
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
8
Number of Fines
2
Total Amount of Fines in Dollars
28795
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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