St. Barbara's Mem Nursing Home - Fairmont Nursing Home
General Information
UPDATEFederal Provider Number
515012
Provider Name
ST. BARBARA'S MEM NURSING HOME
Provider Address
PO BOX 9066
FAIRMONT, WV 26555
FAIRMONT, WV 26555
Provider Phone Number
(304) 534-5220
Provider SSA County
240
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
57
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. BARBARAS MEMORIAL NURSING HOME INC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
4
QM Rating Footnote
Staffing Rating
3
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
2.61250
Reported LPN Staffing Hours per Resident per Day
0.70268
Reported RN Staffing Hours per Resident per Day
0.63393
Reported Licensed Staffing Hours per Resident per Day
1.33661
Reported Total Nurse Staffing Hours per Resident per Day
3.94911
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05089
Expected CNA Staffing Hours per Resident per Day
2.64912
Expected LPN Staffing Hours per Resident per Day
0.64520
Expected RN Staffing Hours per Resident per Day
0.95130
Expected Total Nurse Staffing Hours per Resident per Day
4.24562
Adjusted CNA Staffing Hours per Resident per Day
2.41978
Adjusted LPN Staffing Hours per Resident per Day
0.90394
Adjusted RN Staffing Hours per Resident per Day
0.49792
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74938
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-07-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-03-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-06-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
29.33300
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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