Nc State Veterans Nursing Home - Fayetteville Nursing Home
General Information
UPDATEFederal Provider Number
345492
Provider Name
NC STATE VETERANS NURSING HOME
Provider Address
214 COCHRAN AVENUE
FAYETTEVILLE, NC 28301
FAYETTEVILLE, NC 28301
Provider Phone Number
(910) 482-4131
Provider SSA County
250
Provider County Name
Cumberland
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
150
Number of Residents in Certified Beds
139
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NC DEPARTMENT OF ADMINISTRATION - NC DIVISION OF VETERANS AFFAIRS
Date First Approved to Provide Medicare and Medicaid services
1999-05-11
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
2
Health Inspection Rating Footnote
QM Rating
4
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
2.53201
Reported LPN Staffing Hours per Resident per Day
1.40252
Reported RN Staffing Hours per Resident per Day
0.66547
Reported Licensed Staffing Hours per Resident per Day
2.06799
Reported Total Nurse Staffing Hours per Resident per Day
4.60000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04892
Expected CNA Staffing Hours per Resident per Day
2.52491
Expected LPN Staffing Hours per Resident per Day
0.59489
Expected RN Staffing Hours per Resident per Day
0.93666
Expected Total Nurse Staffing Hours per Resident per Day
4.05645
Adjusted CNA Staffing Hours per Resident per Day
2.46060
Adjusted LPN Staffing Hours per Resident per Day
1.95683
Adjusted RN Staffing Hours per Resident per Day
0.53086
Adjusted Total Nurse Staffing Hours per Resident per Day
4.57102
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
11
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-03-26
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2014-02-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
4550
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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