White Oak Manor - Spartanburg - Spartanburg Nursing Home
General Information
UPDATEFederal Provider Number
425024
Provider Name
WHITE OAK MANOR - SPARTANBURG
Provider Address
295 EAST PEARL STREET
SPARTANBURG, SC 29303
SPARTANBURG, SC 29303
Provider Phone Number
(864) 585-0241
Provider SSA County
410
Provider County Name
Spartanburg
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
192
Number of Residents in Certified Beds
168
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
1967-01-01
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
3
QM Rating Footnote
Staffing Rating
3
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
2.31518
Reported LPN Staffing Hours per Resident per Day
1.11964
Reported RN Staffing Hours per Resident per Day
0.55179
Reported Licensed Staffing Hours per Resident per Day
1.67143
Reported Total Nurse Staffing Hours per Resident per Day
3.98661
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03393
Expected CNA Staffing Hours per Resident per Day
2.42945
Expected LPN Staffing Hours per Resident per Day
0.61368
Expected RN Staffing Hours per Resident per Day
0.94940
Expected Total Nurse Staffing Hours per Resident per Day
3.99253
Adjusted CNA Staffing Hours per Resident per Day
2.33829
Adjusted LPN Staffing Hours per Resident per Day
1.51430
Adjusted RN Staffing Hours per Resident per Day
0.43427
Adjusted Total Nurse Staffing Hours per Resident per Day
4.02492
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-07-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-05-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
14.00000
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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