North Carolina Nursing Homes >> Shelby Nursing Homes >> White Oak Manor - Shelby

White Oak Manor - Shelby - Shelby Nursing Home

General Information

UPDATE
Federal Provider Number
345171
Provider Name
WHITE OAK MANOR - SHELBY
Provider Address
401 N MORGAN STREET
SHELBY, NC 28150
Provider Phone Number
(704) 482-7326
Provider SSA County
220
Provider County Name
Cleveland
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
160
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WHITE OAK MANOR SHELBY INC
Date First Approved to Provide Medicare and Medicaid services
1977-10-26
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
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.90000
Reported LPN Staffing Hours per Resident per Day
1.31765
Reported RN Staffing Hours per Resident per Day
0.61716
Reported Licensed Staffing Hours per Resident per Day
1.93480
Reported Total Nurse Staffing Hours per Resident per Day
4.83481
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05588
Expected CNA Staffing Hours per Resident per Day
2.64033
Expected LPN Staffing Hours per Resident per Day
0.63023
Expected RN Staffing Hours per Resident per Day
0.91583
Expected Total Nurse Staffing Hours per Resident per Day
4.18638
Adjusted CNA Staffing Hours per Resident per Day
2.69501
Adjusted LPN Staffing Hours per Resident per Day
1.73532
Adjusted RN Staffing Hours per Resident per Day
0.50353
Adjusted Total Nurse Staffing Hours per Resident per Day
4.65524
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
5.33300
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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