W R Winslow Memorial Home - Elizabeth City Nursing Home
General Information
UPDATEFederal Provider Number
345036
Provider Name
W R WINSLOW MEMORIAL HOME
Provider Address
1075 US HIGHWAY 17 SOUTH
ELIZABETH CITY, NC 27909
ELIZABETH CITY, NC 27909
Provider Phone Number
2523383975
Provider SSA County
690
Provider County Name
Pasquotank
Ownership Type
Non profit - Church related
Number of Certified Beds
146
Number of Residents in Certified Beds
132
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CAROLINA ADVENTIST RETIREMENT SYSTEMS, INC.
Date First Approved to Provide Medicare and Medicaid services
1967-02-13
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.59091
Reported LPN Staffing Hours per Resident per Day
0.88182
Reported RN Staffing Hours per Resident per Day
0.49773
Reported Licensed Staffing Hours per Resident per Day
1.37955
Reported Total Nurse Staffing Hours per Resident per Day
3.97046
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10720
Expected CNA Staffing Hours per Resident per Day
2.67420
Expected LPN Staffing Hours per Resident per Day
0.64408
Expected RN Staffing Hours per Resident per Day
1.02042
Expected Total Nurse Staffing Hours per Resident per Day
4.33870
Adjusted CNA Staffing Hours per Resident per Day
2.37728
Adjusted LPN Staffing Hours per Resident per Day
1.13637
Adjusted RN Staffing Hours per Resident per Day
0.36446
Adjusted Total Nurse Staffing Hours per Resident per Day
3.68879
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
28
Cycle 1 Standard Survey Health Date
2014-08-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-09-19
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-08-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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
Kindred Transitional Care & Rehab-elizabeth City
901 South Halstead Boulevard |
ELIZABETH CITY NC 27909 | 4.7 miles away
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