Pierpont Center At Fairmont Campus - Fairmont Nursing Home

General Information

UPDATE
Federal Provider Number
515155
Provider Name
PIERPONT CENTER AT FAIRMONT CAMPUS
Provider Address
1543 COUNTRY CLUB ROAD
FAIRMONT, WV 26554
Provider Phone Number
3043632273
Provider SSA County
240
Provider County Name
Marion
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
105
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
1543 COUNTRY CLUB ROAD MANOR OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1997-05-14
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
2.23381
Reported LPN Staffing Hours per Resident per Day
0.70905
Reported RN Staffing Hours per Resident per Day
0.80000
Reported Licensed Staffing Hours per Resident per Day
1.50905
Reported Total Nurse Staffing Hours per Resident per Day
3.74286
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09000
Expected CNA Staffing Hours per Resident per Day
2.56674
Expected LPN Staffing Hours per Resident per Day
0.69914
Expected RN Staffing Hours per Resident per Day
1.22929
Expected Total Nurse Staffing Hours per Resident per Day
4.49517
Adjusted CNA Staffing Hours per Resident per Day
2.13543
Adjusted LPN Staffing Hours per Resident per Day
0.84177
Adjusted RN Staffing Hours per Resident per Day
0.48627
Adjusted Total Nurse Staffing Hours per Resident per Day
3.35629
Cycle 1 Total Number of Health Deficiencies
27
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
192
Cycle 1 Standard Survey Health Date
2014-03-27
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
96
Cycle 1 Total Health Score
288
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2012-08-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
32
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
20
Cycle 3 Health Deficiency Score
212
Cycle 3 Standard Health Survey Date
2009-12-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
212
Total Weighted Health Survey Score
190.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
24
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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