Tygart Center At Fairmont Campus - Fairmont Nursing Home
General Information
UPDATEFederal Provider Number
515053
Provider Name
TYGART CENTER AT FAIRMONT CAMPUS
Provider Address
1539 COUNTRY CLUB ROAD
FAIRMONT, WV 26554
FAIRMONT, WV 26554
Provider Phone Number
(304) 366-9100
Provider SSA County
240
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
119
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
1539 COUNTRY CLUB ROAD OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1975-02-13
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
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.25514
Reported LPN Staffing Hours per Resident per Day
0.77850
Reported RN Staffing Hours per Resident per Day
0.55140
Reported Licensed Staffing Hours per Resident per Day
1.32991
Reported Total Nurse Staffing Hours per Resident per Day
3.58504
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03925
Expected CNA Staffing Hours per Resident per Day
2.50585
Expected LPN Staffing Hours per Resident per Day
0.69008
Expected RN Staffing Hours per Resident per Day
1.23144
Expected Total Nurse Staffing Hours per Resident per Day
4.42738
Adjusted CNA Staffing Hours per Resident per Day
2.20821
Adjusted LPN Staffing Hours per Resident per Day
0.93634
Adjusted RN Staffing Hours per Resident per Day
0.33457
Adjusted Total Nurse Staffing Hours per Resident per Day
3.26400
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-01-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2013-07-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
60.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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