Mansfield Place - Philippi Nursing Home
General Information
UPDATEFederal Provider Number
515129
Provider Name
MANSFIELD PLACE
Provider Address
PO BOX 930
PHILIPPI, WV 26416
PHILIPPI, WV 26416
Provider Phone Number
(304) 457-1760
Provider SSA County
0
Provider County Name
Barbour
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
BROADDUS HOSPITAL ASSOCIATION, INC.
Date First Approved to Provide Medicare and Medicaid services
1994-05-20
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.21000
Reported LPN Staffing Hours per Resident per Day
0.93091
Reported RN Staffing Hours per Resident per Day
0.63455
Reported Licensed Staffing Hours per Resident per Day
1.56545
Reported Total Nurse Staffing Hours per Resident per Day
3.77546
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02091
Expected CNA Staffing Hours per Resident per Day
2.26290
Expected LPN Staffing Hours per Resident per Day
0.60089
Expected RN Staffing Hours per Resident per Day
0.93051
Expected Total Nurse Staffing Hours per Resident per Day
3.79429
Adjusted CNA Staffing Hours per Resident per Day
2.39634
Adjusted LPN Staffing Hours per Resident per Day
1.28586
Adjusted RN Staffing Hours per Resident per Day
0.50954
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01089
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2013-08-27
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
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2012-04-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
100
Cycle 3 Standard Health Survey Date
2009-09-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
100
Total Weighted Health Survey Score
64.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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