Presbyterian Home Of Sc - Summerville - Summerville Nursing Home
General Information
UPDATEFederal Provider Number
425389
Provider Name
PRESBYTERIAN HOME OF SC - SUMMERVILLE
Provider Address
201 W 9TH NORTH STREET
SUMMERVILLE, SC 29483
SUMMERVILLE, SC 29483
Provider Phone Number
(843) 873-2550
Provider SSA County
170
Provider County Name
Dorchester
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
48
Number of Residents in Certified Beds
37
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
PRESBYTERIAN HOME OF SOUTH CAROLINA.
Date First Approved to Provide Medicare and Medicaid services
2009-01-15
Continuing Care Retirement Community
Y
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.98784
Reported LPN Staffing Hours per Resident per Day
0.94189
Reported RN Staffing Hours per Resident per Day
1.62162
Reported Licensed Staffing Hours per Resident per Day
2.56351
Reported Total Nurse Staffing Hours per Resident per Day
5.55135
Reported Physical Therapist Staffing Hours per Resident Per Day
0.34730
Expected CNA Staffing Hours per Resident per Day
2.31307
Expected LPN Staffing Hours per Resident per Day
0.63163
Expected RN Staffing Hours per Resident per Day
1.25378
Expected Total Nurse Staffing Hours per Resident per Day
4.19848
Adjusted CNA Staffing Hours per Resident per Day
3.16949
Adjusted LPN Staffing Hours per Resident per Day
1.23769
Adjusted RN Staffing Hours per Resident per Day
0.96642
Adjusted Total Nurse Staffing Hours per Resident per Day
5.32977
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-05-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-06-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-08-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
58.00000
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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