White Oak Of Waxhaw - Waxhaw Nursing Home
General Information
UPDATEFederal Provider Number
345550
Provider Name
WHITE OAK OF WAXHAW
Provider Address
700 HOWIE MINE ROAD
WAXHAW, NC 28173
WAXHAW, NC 28173
Provider Phone Number
(704) 243-7640
Provider SSA County
890
Provider County Name
Union
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WHITE OAK MANOR-WAXHAW INC
Date First Approved to Provide Medicare and Medicaid services
2010-04-15
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.65103
Reported LPN Staffing Hours per Resident per Day
0.75361
Reported RN Staffing Hours per Resident per Day
0.83093
Reported Licensed Staffing Hours per Resident per Day
1.58454
Reported Total Nurse Staffing Hours per Resident per Day
4.23557
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02938
Expected CNA Staffing Hours per Resident per Day
2.49488
Expected LPN Staffing Hours per Resident per Day
0.66791
Expected RN Staffing Hours per Resident per Day
1.05337
Expected Total Nurse Staffing Hours per Resident per Day
4.21616
Adjusted CNA Staffing Hours per Resident per Day
2.60727
Adjusted LPN Staffing Hours per Resident per Day
0.93650
Adjusted RN Staffing Hours per Resident per Day
0.58941
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04946
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-05-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-03-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
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
20
Cycle 3 Standard Health Survey Date
2012-01-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
20.66700
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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