White Oak Manor - Columbia - Columbia Nursing Home
General Information
UPDATEFederal Provider Number
425068
Provider Name
WHITE OAK MANOR - COLUMBIA
Provider Address
3001 BEECHAVEN ROAD
COLUMBIA, SC 29204
COLUMBIA, SC 29204
Provider Phone Number
(803) 782-4363
Provider SSA County
390
Provider County Name
Richland
Provider Website
Provider Description
Ownership Type
For profit - Corporation
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
WHITE OAK MANOR INC
Date First Approved to Provide Medicare and Medicaid services
1970-02-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
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
2.96215
Reported LPN Staffing Hours per Resident per Day
1.27290
Reported RN Staffing Hours per Resident per Day
0.41636
Reported Licensed Staffing Hours per Resident per Day
1.68925
Reported Total Nurse Staffing Hours per Resident per Day
4.65141
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05327
Expected CNA Staffing Hours per Resident per Day
2.37674
Expected LPN Staffing Hours per Resident per Day
0.64648
Expected RN Staffing Hours per Resident per Day
0.97151
Expected Total Nurse Staffing Hours per Resident per Day
3.99473
Adjusted CNA Staffing Hours per Resident per Day
3.05807
Adjusted LPN Staffing Hours per Resident per Day
1.63424
Adjusted RN Staffing Hours per Resident per Day
0.32023
Adjusted Total Nurse Staffing Hours per Resident per Day
4.69352
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2013-09-12
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2012-08-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-11-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
23.33300
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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