Willow Ridge Of Nc Llc - Rutherfordton Nursing Home
General Information
UPDATEFederal Provider Number
345197
Provider Name
WILLOW RIDGE OF NC LLC
Provider Address
237 TRYON ROAD
RUTHERFORDTON, NC 28139
RUTHERFORDTON, NC 28139
Provider Phone Number
(828) 286-7200
Provider SSA County
800
Provider County Name
Rutherford
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
150
Number of Residents in Certified Beds
111
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WILLOW RIDGE OF NC, LLC
Date First Approved to Provide Medicare and Medicaid services
1980-03-06
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.30946
Reported LPN Staffing Hours per Resident per Day
0.70225
Reported RN Staffing Hours per Resident per Day
0.28243
Reported Licensed Staffing Hours per Resident per Day
0.98468
Reported Total Nurse Staffing Hours per Resident per Day
2.29414
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04820
Expected CNA Staffing Hours per Resident per Day
2.36951
Expected LPN Staffing Hours per Resident per Day
0.58921
Expected RN Staffing Hours per Resident per Day
0.92884
Expected Total Nurse Staffing Hours per Resident per Day
3.88756
Adjusted CNA Staffing Hours per Resident per Day
1.35599
Adjusted LPN Staffing Hours per Resident per Day
0.98923
Adjusted RN Staffing Hours per Resident per Day
0.22720
Adjusted Total Nurse Staffing Hours per Resident per Day
2.37873
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
123
Cycle 1 Standard Survey Health Date
2014-09-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
123
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-06-14
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
18
Cycle 2 Total Health Score
54
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
86.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
10
Number of Fines
3
Total Amount of Fines in Dollars
26375
Number of Payment Denials
1
Total Number of Penalties
4
Location
Processing Date
2015-06-01
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