Winston Salem Nursing & Rehabilitation Center - Winston-salem Nursing Home
General Information
UPDATEFederal Provider Number
345092
Provider Name
WINSTON SALEM NURSING & REHABILITATION CENTER
Provider Address
1900 W 1ST STREET
WINSTON-SALEM, NC 27104
WINSTON-SALEM, NC 27104
Provider Phone Number
(336) 724-2821
Provider SSA County
330
Provider County Name
Forsyth
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
230
Number of Residents in Certified Beds
194
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HEALTHTIQUE WINSTON SALEM, LLC
Date First Approved to Provide Medicare and Medicaid services
1973-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
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
2.30077
Reported LPN Staffing Hours per Resident per Day
0.89536
Reported RN Staffing Hours per Resident per Day
0.66263
Reported Licensed Staffing Hours per Resident per Day
1.55799
Reported Total Nurse Staffing Hours per Resident per Day
3.85876
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04149
Expected CNA Staffing Hours per Resident per Day
2.57079
Expected LPN Staffing Hours per Resident per Day
0.74557
Expected RN Staffing Hours per Resident per Day
1.22304
Expected Total Nurse Staffing Hours per Resident per Day
4.53941
Adjusted CNA Staffing Hours per Resident per Day
2.19597
Adjusted LPN Staffing Hours per Resident per Day
0.99675
Adjusted RN Staffing Hours per Resident per Day
0.40482
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42650
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-06-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
29.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
10
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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