Sistersville Center - Sistersville Nursing Home
General Information
UPDATEFederal Provider Number
515131
Provider Name
SISTERSVILLE CENTER
Provider Address
201 WOOD STREET OPERATIONS, LLC
SISTERSVILLE, WV 26175
SISTERSVILLE, WV 26175
Provider Phone Number
(304) 652-1032
Provider SSA County
470
Provider County Name
Tyler
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
68
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
201 WOOD STREET OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1994-08-31
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.93981
Reported LPN Staffing Hours per Resident per Day
0.64537
Reported RN Staffing Hours per Resident per Day
0.85926
Reported Licensed Staffing Hours per Resident per Day
1.50463
Reported Total Nurse Staffing Hours per Resident per Day
3.44444
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07407
Expected CNA Staffing Hours per Resident per Day
2.33161
Expected LPN Staffing Hours per Resident per Day
0.67677
Expected RN Staffing Hours per Resident per Day
1.27977
Expected Total Nurse Staffing Hours per Resident per Day
4.28816
Adjusted CNA Staffing Hours per Resident per Day
2.04138
Adjusted LPN Staffing Hours per Resident per Day
0.79149
Adjusted RN Staffing Hours per Resident per Day
0.50168
Adjusted Total Nurse Staffing Hours per Resident per Day
3.23780
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
28
Cycle 1 Standard Survey Health Date
2014-02-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2012-08-03
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2010-03-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
17.33300
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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