Magnolia Manor - Spartanburg - Spartanburg Nursing Home
General Information
UPDATEFederal Provider Number
425091
Provider Name
MAGNOLIA MANOR - SPARTANBURG
Provider Address
375 SERPENTINE DRIVE
SPARTANBURG, SC 29305
SPARTANBURG, SC 29305
Provider Phone Number
(864) 585-0218
Provider SSA County
410
Provider County Name
Spartanburg
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
95
Number of Residents in Certified Beds
80
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THI OF SOUTH CAROLINA AT SPARTANBURG, LLC
Date First Approved to Provide Medicare and Medicaid services
1978-04-01
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
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.12250
Reported LPN Staffing Hours per Resident per Day
0.78813
Reported RN Staffing Hours per Resident per Day
0.27750
Reported Licensed Staffing Hours per Resident per Day
1.06563
Reported Total Nurse Staffing Hours per Resident per Day
3.18813
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03813
Expected CNA Staffing Hours per Resident per Day
2.54487
Expected LPN Staffing Hours per Resident per Day
0.59573
Expected RN Staffing Hours per Resident per Day
1.01028
Expected Total Nurse Staffing Hours per Resident per Day
4.15088
Adjusted CNA Staffing Hours per Resident per Day
2.04646
Adjusted LPN Staffing Hours per Resident per Day
1.09806
Adjusted RN Staffing Hours per Resident per Day
0.20524
Adjusted Total Nurse Staffing Hours per Resident per Day
3.09598
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-06-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
17
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
11
Cycle 3 Health Deficiency Score
140
Cycle 3 Standard Health Survey Date
2012-04-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
140
Total Weighted Health Survey Score
77.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
Number of Fines
6
Total Amount of Fines in Dollars
66172
Number of Payment Denials
0
Total Number of Penalties
6
Location
Processing Date
2015-06-01
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