Premier Living And Rehab Center - Lake Waccamaw Nursing Home
General Information
UPDATEFederal Provider Number
345185
Provider Name
PREMIER LIVING AND REHAB CENTER
Provider Address
106 CAMERON STREET
LAKE WACCAMAW, NC 28450
LAKE WACCAMAW, NC 28450
Provider Phone Number
(910) 646-3132
Provider SSA County
230
Provider County Name
Columbus
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
127
Number of Residents in Certified Beds
99
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PREMIER LIVING AND REHAB CENTER
Date First Approved to Provide Medicare and Medicaid services
1978-09-29
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
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.48333
Reported LPN Staffing Hours per Resident per Day
1.22727
Reported RN Staffing Hours per Resident per Day
0.56818
Reported Licensed Staffing Hours per Resident per Day
1.79545
Reported Total Nurse Staffing Hours per Resident per Day
4.27878
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06010
Expected CNA Staffing Hours per Resident per Day
2.36514
Expected LPN Staffing Hours per Resident per Day
0.70897
Expected RN Staffing Hours per Resident per Day
1.15752
Expected Total Nurse Staffing Hours per Resident per Day
4.23163
Adjusted CNA Staffing Hours per Resident per Day
2.57631
Adjusted LPN Staffing Hours per Resident per Day
1.43678
Adjusted RN Staffing Hours per Resident per Day
0.36677
Adjusted Total Nurse Staffing Hours per Resident per Day
4.07581
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-04-09
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2014-05-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-04-17
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
21.33300
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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