Person Memorial Hospital - Roxboro Nursing Home

General Information

UPDATE
Federal Provider Number
345004
Provider Name
PERSON MEMORIAL HOSPITAL
Provider Address
615 RIDGE ROAD
ROXBORO, NC 27573
Provider Phone Number
(336) 503-5707
Provider SSA County
720
Provider County Name
Person
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DLP PERSON MEMORIAL HOSPITAL LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
3
QM Rating Footnote
Staffing Rating
3
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
2.17019
Reported LPN Staffing Hours per Resident per Day
0.80962
Reported RN Staffing Hours per Resident per Day
0.68654
Reported Licensed Staffing Hours per Resident per Day
1.49615
Reported Total Nurse Staffing Hours per Resident per Day
3.66635
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12596
Expected CNA Staffing Hours per Resident per Day
2.45806
Expected LPN Staffing Hours per Resident per Day
0.72716
Expected RN Staffing Hours per Resident per Day
1.20346
Expected Total Nurse Staffing Hours per Resident per Day
4.38868
Adjusted CNA Staffing Hours per Resident per Day
2.16634
Adjusted LPN Staffing Hours per Resident per Day
0.92412
Adjusted RN Staffing Hours per Resident per Day
0.42626
Adjusted Total Nurse Staffing Hours per Resident per Day
3.36745
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-12-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-09-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-07-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
52.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
8125
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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