Trinity Village - Hickory Nursing Home
General Information
UPDATEFederal Provider Number
345152
Provider Name
TRINITY VILLAGE
Provider Address
1265 21 STREET NE
HICKORY, NC 28601
HICKORY, NC 28601
Provider Phone Number
8283282006
Provider SSA County
170
Provider County Name
Catawba
Ownership Type
Non profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN HOME-HICKORY, INC.
Date First Approved to Provide Medicare and Medicaid services
1976-07-01
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
4.11316
Reported LPN Staffing Hours per Resident per Day
1.09158
Reported RN Staffing Hours per Resident per Day
0.95632
Reported Licensed Staffing Hours per Resident per Day
2.04789
Reported Total Nurse Staffing Hours per Resident per Day
6.16106
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05789
Expected CNA Staffing Hours per Resident per Day
2.77440
Expected LPN Staffing Hours per Resident per Day
0.67452
Expected RN Staffing Hours per Resident per Day
1.08859
Expected Total Nurse Staffing Hours per Resident per Day
4.53752
Adjusted CNA Staffing Hours per Resident per Day
3.63770
Adjusted LPN Staffing Hours per Resident per Day
1.34319
Adjusted RN Staffing Hours per Resident per Day
0.65641
Adjusted Total Nurse Staffing Hours per Resident per Day
5.47317
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-04-30
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-12-18
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
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
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
Nursiong Homes Nearby
Brian Ctr Health & Rehabi Hick
3031 Tate Boulevard Se |
HICKORY NC 28602 | 2.2 miles away
Brian Center Health & Rehab Hickory Viewmont
220 13th Avenue Place Nw |
HICKORY NC 28601 | 2.5 miles away
Conover Nursing And Rehab Ctr
920 4th Street South West |
CONOVER NC 28613 | 4.6 miles away
Trinity Ridge
2140 Medical Park Drive |
HICKORY NC 28602 | 5.1 miles away
Abernethy Laurels
102 Leonard Avenue |
NEWTON NC 28658 | 9.5 miles away
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