Trinity Ridge - Hickory Nursing Home
General Information
UPDATEFederal Provider Number
345106
Provider Name
TRINITY RIDGE
Provider Address
2140 MEDICAL PARK DRIVE
HICKORY, NC 28602
HICKORY, NC 28602
Provider Phone Number
(828) 322-6995
Provider SSA County
170
Provider County Name
Catawba
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
120
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN HOME - HICKORY WEST, INC
Date First Approved to Provide Medicare and Medicaid services
1973-12-10
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
3.41121
Reported LPN Staffing Hours per Resident per Day
0.85981
Reported RN Staffing Hours per Resident per Day
0.94766
Reported Licensed Staffing Hours per Resident per Day
1.80748
Reported Total Nurse Staffing Hours per Resident per Day
5.21868
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12897
Expected CNA Staffing Hours per Resident per Day
2.76160
Expected LPN Staffing Hours per Resident per Day
0.71671
Expected RN Staffing Hours per Resident per Day
1.17127
Expected Total Nurse Staffing Hours per Resident per Day
4.64957
Adjusted CNA Staffing Hours per Resident per Day
3.03089
Adjusted LPN Staffing Hours per Resident per Day
0.99572
Adjusted RN Staffing Hours per Resident per Day
0.60455
Adjusted Total Nurse Staffing Hours per Resident per Day
4.52428
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-02-06
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2012-11-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
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
16
Cycle 3 Standard Health Survey Date
2011-10-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
4.00000
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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