Rolling Green Village - Greenville Nursing Home

General Information

UPDATE
Federal Provider Number
425160
Provider Name
ROLLING GREEN VILLAGE
Provider Address
1 HOKE SMITH BOULEVARD
GREENVILLE, SC 29615
Provider Phone Number
8649879800
Provider SSA County
220
Provider County Name
Greenville
Ownership Type
For profit - Corporation
Number of Certified Beds
74
Number of Residents in Certified Beds
68
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
ROLLING GREEN VILLAGE
Date First Approved to Provide Medicare and Medicaid services
1986-12-12
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
1.66691
Reported LPN Staffing Hours per Resident per Day
1.40662
Reported RN Staffing Hours per Resident per Day
1.03529
Reported Licensed Staffing Hours per Resident per Day
2.44191
Reported Total Nurse Staffing Hours per Resident per Day
4.10882
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15515
Expected CNA Staffing Hours per Resident per Day
2.60187
Expected LPN Staffing Hours per Resident per Day
0.64645
Expected RN Staffing Hours per Resident per Day
1.03557
Expected Total Nurse Staffing Hours per Resident per Day
4.28389
Adjusted CNA Staffing Hours per Resident per Day
1.57198
Adjusted LPN Staffing Hours per Resident per Day
1.80601
Adjusted RN Staffing Hours per Resident per Day
0.74700
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86617
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-12-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-04-18
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
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
2012-05-30
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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