Southwood Nursing And Retireme - Clinton Nursing Home
General Information
UPDATEFederal Provider Number
345472
Provider Name
SOUTHWOOD NURSING AND RETIREME
Provider Address
180 SOUTHWOOD DRIVE BOX 708
CLINTON, NC 28328
CLINTON, NC 28328
Provider Phone Number
(910) 592-8165
Provider SSA County
810
Provider County Name
Sampson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY HEALTHCARE GROUP LLC
Date First Approved to Provide Medicare and Medicaid services
1995-04-17
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
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.70816
Reported LPN Staffing Hours per Resident per Day
1.29184
Reported RN Staffing Hours per Resident per Day
0.31173
Reported Licensed Staffing Hours per Resident per Day
1.60357
Reported Total Nurse Staffing Hours per Resident per Day
3.31173
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01837
Expected CNA Staffing Hours per Resident per Day
2.59806
Expected LPN Staffing Hours per Resident per Day
0.61707
Expected RN Staffing Hours per Resident per Day
0.92862
Expected Total Nurse Staffing Hours per Resident per Day
4.14375
Adjusted CNA Staffing Hours per Resident per Day
1.61325
Adjusted LPN Staffing Hours per Resident per Day
1.73762
Adjusted RN Staffing Hours per Resident per Day
0.25083
Adjusted Total Nurse Staffing Hours per Resident per Day
3.22154
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-04-09
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
20
Cycle 2 Standard Health Survey Date
2014-05-09
Cycle 2 Number of Health Revisits
1
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
8
Cycle 3 Standard Health Survey Date
2013-04-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
8.00000
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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