Rich Square Health Care Center - Rich Square Nursing Home
General Information
UPDATEFederal Provider Number
345356
Provider Name
RICH SQUARE HEALTH CARE CENTER
Provider Address
300 NORTH MAIN STREET
RICH SQUARE, NC 27869
RICH SQUARE, NC 27869
Provider Phone Number
(252) 539-3901
Provider SSA County
650
Provider County Name
Northampton
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
69
Number of Residents in Certified Beds
66
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RV NURSING HOME, LLC
Date First Approved to Provide Medicare and Medicaid services
1991-02-19
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
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
2.19242
Reported LPN Staffing Hours per Resident per Day
0.84621
Reported RN Staffing Hours per Resident per Day
0.49394
Reported Licensed Staffing Hours per Resident per Day
1.34015
Reported Total Nurse Staffing Hours per Resident per Day
3.53257
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07121
Expected CNA Staffing Hours per Resident per Day
2.60751
Expected LPN Staffing Hours per Resident per Day
0.65019
Expected RN Staffing Hours per Resident per Day
1.03277
Expected Total Nurse Staffing Hours per Resident per Day
4.29047
Adjusted CNA Staffing Hours per Resident per Day
2.06309
Adjusted LPN Staffing Hours per Resident per Day
1.08023
Adjusted RN Staffing Hours per Resident per Day
0.35736
Adjusted Total Nurse Staffing Hours per Resident per Day
3.31885
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-01-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-12-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
4160
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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