Shenandoah Nursing Home - Fishersville Nursing Home
General Information
UPDATEFederal Provider Number
495262
Provider Name
SHENANDOAH NURSING HOME
Provider Address
339 WESTMINISTER DRIVE
FISHERSVILLE, VA 22939
FISHERSVILLE, VA 22939
Provider Phone Number
(540) 949-8665
Provider SSA County
70
Provider County Name
Augusta
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AUTUMN CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1991-08-27
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
4
Health Inspection Rating Footnote
QM Rating
1
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
2.32193
Reported LPN Staffing Hours per Resident per Day
0.91404
Reported RN Staffing Hours per Resident per Day
0.46842
Reported Licensed Staffing Hours per Resident per Day
1.38246
Reported Total Nurse Staffing Hours per Resident per Day
3.70439
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18947
Expected CNA Staffing Hours per Resident per Day
2.54191
Expected LPN Staffing Hours per Resident per Day
0.65029
Expected RN Staffing Hours per Resident per Day
1.11933
Expected Total Nurse Staffing Hours per Resident per Day
4.31152
Adjusted CNA Staffing Hours per Resident per Day
2.24135
Adjusted LPN Staffing Hours per Resident per Day
1.16664
Adjusted RN Staffing Hours per Resident per Day
0.31269
Adjusted Total Nurse Staffing Hours per Resident per Day
3.46328
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-02-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-03-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-03-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
18.66700
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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