White Oak Manor - Rutherfordto - Rutherfordton Nursing Home
General Information
UPDATEFederal Provider Number
345083
Provider Name
WHITE OAK MANOR - RUTHERFORDTO
Provider Address
188 OSCAR JUSTICE ROAD
RUTHERFORDTON, NC 28139
RUTHERFORDTON, NC 28139
Provider Phone Number
(828) 286-9001
Provider SSA County
800
Provider County Name
Rutherford
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WHITE OAK MANOR RUTHERFORDTON INC
Date First Approved to Provide Medicare and Medicaid services
1972-12-13
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
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
3.08446
Reported LPN Staffing Hours per Resident per Day
1.23919
Reported RN Staffing Hours per Resident per Day
0.49527
Reported Licensed Staffing Hours per Resident per Day
1.73446
Reported Total Nurse Staffing Hours per Resident per Day
4.81892
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03581
Expected CNA Staffing Hours per Resident per Day
2.50674
Expected LPN Staffing Hours per Resident per Day
0.68426
Expected RN Staffing Hours per Resident per Day
1.21363
Expected Total Nurse Staffing Hours per Resident per Day
4.40463
Adjusted CNA Staffing Hours per Resident per Day
3.01920
Adjusted LPN Staffing Hours per Resident per Day
1.50313
Adjusted RN Staffing Hours per Resident per Day
0.30492
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41004
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
2014-09-25
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-06-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
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
4
Cycle 3 Standard Health Survey Date
2012-05-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
3.33300
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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