Woodhaven Nurs & Alzheimer's C - Lumberton Nursing Home
General Information
UPDATEFederal Provider Number
345054
Provider Name
WOODHAVEN NURS & ALZHEIMER'S C
Provider Address
1150 PINE RUN DRIVE
LUMBERTON, NC 28358
LUMBERTON, NC 28358
Provider Phone Number
(910) 671-5703
Provider SSA County
770
Provider County Name
Robeson
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
115
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
SOUTHEASTERN REGIONAL MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
1969-05-15
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
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
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.89579
Reported LPN Staffing Hours per Resident per Day
1.64953
Reported RN Staffing Hours per Resident per Day
0.55421
Reported Licensed Staffing Hours per Resident per Day
2.20374
Reported Total Nurse Staffing Hours per Resident per Day
5.09953
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01916
Expected CNA Staffing Hours per Resident per Day
2.58950
Expected LPN Staffing Hours per Resident per Day
0.66104
Expected RN Staffing Hours per Resident per Day
1.02502
Expected Total Nurse Staffing Hours per Resident per Day
4.27555
Adjusted CNA Staffing Hours per Resident per Day
2.74393
Adjusted LPN Staffing Hours per Resident per Day
2.07116
Adjusted RN Staffing Hours per Resident per Day
0.40400
Adjusted Total Nurse Staffing Hours per Resident per Day
4.80773
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-09-18
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-08-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
32.66700
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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