Trinity Oaks - Salisbury Nursing Home

General Information

UPDATE
Federal Provider Number
345153
Provider Name
TRINITY OAKS
Provider Address
820 KLUMAC ROAD
SALISBURY, NC 28144
Provider Phone Number
7046373784
Provider SSA County
790
Provider County Name
Rowan
Ownership Type
Non profit - Church related
Number of Certified Beds
115
Number of Residents in Certified Beds
108
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN HOME AT TRINITY OAKS, INC.
Date First Approved to Provide Medicare and Medicaid services
1976-04-01
Continuing Care Retirement Community
Y
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
3
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.70463
Reported LPN Staffing Hours per Resident per Day
0.51991
Reported RN Staffing Hours per Resident per Day
0.93611
Reported Licensed Staffing Hours per Resident per Day
1.45602
Reported Total Nurse Staffing Hours per Resident per Day
5.16065
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10602
Expected CNA Staffing Hours per Resident per Day
2.52843
Expected LPN Staffing Hours per Resident per Day
0.57888
Expected RN Staffing Hours per Resident per Day
0.98457
Expected Total Nurse Staffing Hours per Resident per Day
4.09188
Adjusted CNA Staffing Hours per Resident per Day
3.59514
Adjusted LPN Staffing Hours per Resident per Day
0.74545
Adjusted RN Staffing Hours per Resident per Day
0.71043
Adjusted Total Nurse Staffing Hours per Resident per Day
5.08374
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-12-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-09-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-08-16
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
15243
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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