Petra Health & Rehab Of Mccormick - Mc Cormick Nursing Home
General Information
UPDATEFederal Provider Number
425171
Provider Name
PETRA HEALTH & REHAB OF MCCORMICK
Provider Address
204 HOLIDAY ROAD
MC CORMICK, SC 29835
MC CORMICK, SC 29835
Provider Phone Number
(864) 391-2390
Provider SSA County
320
Provider County Name
Mccormick
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NEW PETRA HEALTH & REHAB OF MCCORMICK LLC
Date First Approved to Provide Medicare and Medicaid services
1989-02-15
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
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
1.97652
Reported LPN Staffing Hours per Resident per Day
0.72043
Reported RN Staffing Hours per Resident per Day
0.50043
Reported Licensed Staffing Hours per Resident per Day
1.22087
Reported Total Nurse Staffing Hours per Resident per Day
3.19738
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05217
Expected CNA Staffing Hours per Resident per Day
2.49119
Expected LPN Staffing Hours per Resident per Day
0.59360
Expected RN Staffing Hours per Resident per Day
0.88250
Expected Total Nurse Staffing Hours per Resident per Day
3.96728
Adjusted CNA Staffing Hours per Resident per Day
1.94678
Adjusted LPN Staffing Hours per Resident per Day
1.00734
Adjusted RN Staffing Hours per Resident per Day
0.42371
Adjusted Total Nurse Staffing Hours per Resident per Day
3.24865
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-05-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2012-12-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
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
8
Cycle 3 Standard Health Survey Date
2011-11-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
10.66700
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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