Montgomery General Hosp., D/p - Montgomery Nursing Home
General Information
UPDATEFederal Provider Number
515081
Provider Name
MONTGOMERY GENERAL HOSP., D/P
Provider Address
WASHINGTON STREET AND 6TH AVENUE
MONTGOMERY, WV 25136
MONTGOMERY, WV 25136
Provider Phone Number
(304) 442-5151
Provider SSA County
90
Provider County Name
Fayette
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1988-02-03
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.38676
Reported LPN Staffing Hours per Resident per Day
1.17647
Reported RN Staffing Hours per Resident per Day
0.57941
Reported Licensed Staffing Hours per Resident per Day
1.75588
Reported Total Nurse Staffing Hours per Resident per Day
4.14264
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16765
Expected CNA Staffing Hours per Resident per Day
2.26570
Expected LPN Staffing Hours per Resident per Day
0.54940
Expected RN Staffing Hours per Resident per Day
0.97752
Expected Total Nurse Staffing Hours per Resident per Day
3.79262
Adjusted CNA Staffing Hours per Resident per Day
2.58480
Adjusted LPN Staffing Hours per Resident per Day
1.77735
Adjusted RN Staffing Hours per Resident per Day
0.44289
Adjusted Total Nurse Staffing Hours per Resident per Day
4.40291
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2015-03-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-07-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
63.33300
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
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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