The Graybrier Nurs & Retirement Ct - Trinity Nursing Home
General Information
UPDATEFederal Provider Number
345330
Provider Name
THE GRAYBRIER NURS & RETIREMENT CT
Provider Address
116 LANE DRIVE
TRINITY, NC 27370
TRINITY, NC 27370
Provider Phone Number
(336) 431-8888
Provider SSA County
750
Provider County Name
Randolph
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
128
Number of Residents in Certified Beds
113
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ARCHDALE NURSING CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1990-11-08
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
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.59735
Reported LPN Staffing Hours per Resident per Day
0.92345
Reported RN Staffing Hours per Resident per Day
0.75929
Reported Licensed Staffing Hours per Resident per Day
1.68274
Reported Total Nurse Staffing Hours per Resident per Day
4.28009
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09336
Expected CNA Staffing Hours per Resident per Day
2.50565
Expected LPN Staffing Hours per Resident per Day
0.64537
Expected RN Staffing Hours per Resident per Day
1.02760
Expected Total Nurse Staffing Hours per Resident per Day
4.17861
Adjusted CNA Staffing Hours per Resident per Day
2.54350
Adjusted LPN Staffing Hours per Resident per Day
1.18764
Adjusted RN Staffing Hours per Resident per Day
0.55210
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12879
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
2013-08-15
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
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
75
Cycle 3 Standard Health Survey Date
2012-05-22
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
75
Total Weighted Health Survey Score
22.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
100133
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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