Myrtle Beach Manor - Myrtle Beach Nursing Home
General Information
UPDATEFederal Provider Number
425070
Provider Name
MYRTLE BEACH MANOR
Provider Address
9547 HIGHWAY 17, NORTH
MYRTLE BEACH, SC 29572
MYRTLE BEACH, SC 29572
Provider Phone Number
(843) 449-5283
Provider SSA County
250
Provider County Name
Horry
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
50
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
FS TENANT POOL I TRUST
Date First Approved to Provide Medicare and Medicaid services
1970-07-09
Continuing Care Retirement Community
Y
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
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.59400
Reported LPN Staffing Hours per Resident per Day
1.14700
Reported RN Staffing Hours per Resident per Day
0.92300
Reported Licensed Staffing Hours per Resident per Day
2.07000
Reported Total Nurse Staffing Hours per Resident per Day
4.66400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.27500
Expected CNA Staffing Hours per Resident per Day
2.51678
Expected LPN Staffing Hours per Resident per Day
0.73163
Expected RN Staffing Hours per Resident per Day
1.29121
Expected Total Nurse Staffing Hours per Resident per Day
4.53962
Adjusted CNA Staffing Hours per Resident per Day
2.52898
Adjusted LPN Staffing Hours per Resident per Day
1.30122
Adjusted RN Staffing Hours per Resident per Day
0.53412
Adjusted Total Nurse Staffing Hours per Resident per Day
4.14134
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-01-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2012-09-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-07-20
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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