North Carolina Nursing Homes >> Mount Airy Nursing Homes >> Northern Surry Snf

Northern Surry Snf - Mount Airy Nursing Home

General Information

UPDATE
Federal Provider Number
345278
Provider Name
NORTHERN SURRY SNF
Provider Address
830 ROCKFORD STREET
MOUNT AIRY, NC 27030
Provider Phone Number
(336) 719-7000
Provider SSA County
850
Provider County Name
Surry
Provider Website
Provider Description
Ownership Type
Government - Hospital district
Number of Certified Beds
33
Number of Residents in Certified Beds
32
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
NORTHERN HOSPITAL OF SURRY COUNTY
Date First Approved to Provide Medicare and Medicaid services
1988-05-25
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
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
2.61094
Reported LPN Staffing Hours per Resident per Day
1.25000
Reported RN Staffing Hours per Resident per Day
0.53594
Reported Licensed Staffing Hours per Resident per Day
1.78594
Reported Total Nurse Staffing Hours per Resident per Day
4.39688
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04531
Expected CNA Staffing Hours per Resident per Day
2.38289
Expected LPN Staffing Hours per Resident per Day
0.53080
Expected RN Staffing Hours per Resident per Day
0.71500
Expected Total Nurse Staffing Hours per Resident per Day
3.62869
Adjusted CNA Staffing Hours per Resident per Day
2.68853
Adjusted LPN Staffing Hours per Resident per Day
1.95459
Adjusted RN Staffing Hours per Resident per Day
0.56008
Adjusted Total Nurse Staffing Hours per Resident per Day
4.88424
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2015-04-23
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2014-01-08
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
0
Cycle 3 Standard Health Survey Date
2012-11-16
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
20.66700
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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