Willowbrooke Court Sc Ctr At Tryon Estates - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
345459
Provider Name
WILLOWBROOKE COURT SC CTR AT TRYON ESTATES
Provider Address
619 LAUREL LAKE DRIVE
COLUMBUS, NC 28722
COLUMBUS, NC 28722
Provider Phone Number
(828) 894-5500
Provider SSA County
740
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
33
Number of Residents in Certified Beds
25
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
ACTS RETIREMENT-LIFE COMMUNITIES INC
Date First Approved to Provide Medicare and Medicaid services
1994-06-03
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
4
Health Inspection Rating Footnote
QM Rating
3
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
2.04600
Reported LPN Staffing Hours per Resident per Day
0.70800
Reported RN Staffing Hours per Resident per Day
1.54800
Reported Licensed Staffing Hours per Resident per Day
2.25600
Reported Total Nurse Staffing Hours per Resident per Day
4.30200
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22000
Expected CNA Staffing Hours per Resident per Day
2.49001
Expected LPN Staffing Hours per Resident per Day
0.72429
Expected RN Staffing Hours per Resident per Day
1.11417
Expected Total Nurse Staffing Hours per Resident per Day
4.32848
Adjusted CNA Staffing Hours per Resident per Day
2.01616
Adjusted LPN Staffing Hours per Resident per Day
0.81133
Adjusted RN Staffing Hours per Resident per Day
1.03814
Adjusted Total Nurse Staffing Hours per Resident per Day
4.00624
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
8
Cycle 1 Standard Survey Health Date
2014-04-16
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
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-02-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
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
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
9.33300
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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