Pine Lodge - Beckley Nursing Home
General Information
UPDATEFederal Provider Number
515001
Provider Name
PINE LODGE
Provider Address
405 STANAFORD ROAD
BECKLEY, WV 25801
BECKLEY, WV 25801
Provider Phone Number
(304) 252-6317
Provider SSA County
400
Provider County Name
Raleigh
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
108
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SUNBRIDGE BECKLEY HEALTH CARE CORP.
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
Both
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
1
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
2.11806
Reported LPN Staffing Hours per Resident per Day
0.89074
Reported RN Staffing Hours per Resident per Day
0.68102
Reported Licensed Staffing Hours per Resident per Day
1.57176
Reported Total Nurse Staffing Hours per Resident per Day
3.68982
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02454
Expected CNA Staffing Hours per Resident per Day
2.46699
Expected LPN Staffing Hours per Resident per Day
0.70929
Expected RN Staffing Hours per Resident per Day
1.28233
Expected Total Nurse Staffing Hours per Resident per Day
4.45860
Adjusted CNA Staffing Hours per Resident per Day
2.10665
Adjusted LPN Staffing Hours per Resident per Day
1.04234
Adjusted RN Staffing Hours per Resident per Day
0.39682
Adjusted Total Nurse Staffing Hours per Resident per Day
3.33587
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
20
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
152
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
76
Cycle 1 Total Health Score
228
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-09-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-03-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
143.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
11
Number of Fines
1
Total Amount of Fines in Dollars
27300
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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