Mary Gran Nursing Center - Clinton Nursing Home
General Information
UPDATEFederal Provider Number
345218
Provider Name
MARY GRAN NURSING CENTER
Provider Address
120 SOUTHWOOD DRIVE BOX 379
CLINTON, NC 28328
CLINTON, NC 28328
Provider Phone Number
(910) 592-7981
Provider SSA County
810
Provider County Name
Sampson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
212
Number of Residents in Certified Beds
136
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY HEALTHCARE GROUP LLC
Date First Approved to Provide Medicare and Medicaid services
1981-10-01
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
2
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
2.17022
Reported LPN Staffing Hours per Resident per Day
0.77941
Reported RN Staffing Hours per Resident per Day
0.34632
Reported Licensed Staffing Hours per Resident per Day
1.12574
Reported Total Nurse Staffing Hours per Resident per Day
3.29595
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04301
Expected CNA Staffing Hours per Resident per Day
2.53357
Expected LPN Staffing Hours per Resident per Day
0.63505
Expected RN Staffing Hours per Resident per Day
1.00482
Expected Total Nurse Staffing Hours per Resident per Day
4.17345
Adjusted CNA Staffing Hours per Resident per Day
2.10180
Adjusted LPN Staffing Hours per Resident per Day
1.01868
Adjusted RN Staffing Hours per Resident per Day
0.25753
Adjusted Total Nurse Staffing Hours per Resident per Day
3.18337
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
225
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
225
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-09-06
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-08-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
117.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
36270
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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