Smithfield Manor Inc - Smithfield Nursing Home
General Information
UPDATEFederal Provider Number
345175
Provider Name
SMITHFIELD MANOR INC
Provider Address
POST OFFICE BOX 1940
SMITHFIELD, NC 27577
SMITHFIELD, NC 27577
Provider Phone Number
(919) 934-3171
Provider SSA County
500
Provider County Name
Johnston
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
160
Number of Residents in Certified Beds
151
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SMITHFIELD MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
1977-12-01
Continuing Care Retirement Community
N
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
1.95728
Reported LPN Staffing Hours per Resident per Day
0.53179
Reported RN Staffing Hours per Resident per Day
0.60960
Reported Licensed Staffing Hours per Resident per Day
1.14139
Reported Total Nurse Staffing Hours per Resident per Day
3.09867
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02351
Expected CNA Staffing Hours per Resident per Day
2.59792
Expected LPN Staffing Hours per Resident per Day
0.61586
Expected RN Staffing Hours per Resident per Day
0.98104
Expected Total Nurse Staffing Hours per Resident per Day
4.19482
Adjusted CNA Staffing Hours per Resident per Day
1.84862
Adjusted LPN Staffing Hours per Resident per Day
0.71670
Adjusted RN Staffing Hours per Resident per Day
0.46429
Adjusted Total Nurse Staffing Hours per Resident per Day
2.97758
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-01-29
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
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-12-12
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-10-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
33.33300
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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