Whitestone A Masonic And Eastern Star Community - Greensboro Nursing Home
General Information
UPDATEFederal Provider Number
345506
Provider Name
WHITESTONE A MASONIC AND EASTERN STAR COMMUNITY
Provider Address
700 SOUTH HOLDEN ROAD
GREENSBORO, NC 27407
GREENSBORO, NC 27407
Provider Phone Number
(336) 299-0031
Provider SSA County
400
Provider County Name
Guilford
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MASONIC AND EASTERN STAR HOME OF NC INC
Date First Approved to Provide Medicare and Medicaid services
2000-10-26
Continuing Care Retirement Community
Y
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.67807
Reported LPN Staffing Hours per Resident per Day
0.83333
Reported RN Staffing Hours per Resident per Day
1.12807
Reported Licensed Staffing Hours per Resident per Day
1.96140
Reported Total Nurse Staffing Hours per Resident per Day
4.63947
Reported Physical Therapist Staffing Hours per Resident Per Day
0.29298
Expected CNA Staffing Hours per Resident per Day
2.50506
Expected LPN Staffing Hours per Resident per Day
0.60500
Expected RN Staffing Hours per Resident per Day
1.12890
Expected Total Nurse Staffing Hours per Resident per Day
4.23895
Adjusted CNA Staffing Hours per Resident per Day
2.62316
Adjusted LPN Staffing Hours per Resident per Day
1.14325
Adjusted RN Staffing Hours per Resident per Day
0.74665
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41176
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
2014-11-19
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
2
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
79
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
79
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-08-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
34.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
2
Total Amount of Fines in Dollars
10000
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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