Provider Name: WILLOWBROOKE COURT SC CTR AT MATTHEWS GLEN
Address: 740 PAVILION VIEW DRIVE, MATTHEWS, NC 28105
Phone: (704) 845-6220
County: Mecklenburg (590)
Ownership Type: Non profit - Corporation
Certified Beds: 15
Average Residents Per Day: 7.9 ()
Provider Type: Medicare, Resides in Hospital: No
Legal Business Name: ACTS RETIREMENT-LIFE COMMUNITIES INC
First Approved Date: September 6, 1990
Affiliated Entity: ACTS RETIREMENT-LIFE COMMUNITIES (9)
Retirement Community: Y, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 5 ()
QM Rating: 5 ()
Long Stay QM Rating: (2)
Short Stay QM Rating: 5 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.54790, LPN Staff Hours Per Day: 1.3602, RN Staff Hours Per Day: 1.3847, Licensed Staff Hours Per Day: 2.7450
Total Nurse Staff Hours Per Day, per resident: 5.29295
Weekend Nurse Staff Hours: 4.84352, Weekend RN Staff Hours: 1.2348
PT Staff Hours Per Day, per resident: 2.2856
Nurse Staff Turnover: , Nurse Turnover Note: 6
RN Turnover: , RN Turnover Note: 6
Admin Left Number: , Admin Turnover Note: 6
Case Mix Nurse Aide Hours Per Day, per resident: 1.6759, Case Mix LPN Hours Per Day: 0.8060, Case Mix RN Hours Per Day: 0.4237
Adjusted Nurse Aide Hours Per Day, per resident: 3.09720, Adjusted LPN Hours Per Day: 1.2453, Adjusted RN Hours Per Day: 1.2314
Total Adjusted Nurse Hours Per Day, per resident: 5.74153
Adjusted Weekend Nurse Hours Per Day, per resident: 5.25401
Health Survey Dates and Scores: Cycle 1: 2023-05-11 (Score: 0), Cycle 2: 2022-03-02 (Score: 12), Cycle 3: 2020-01-08 (Score: 4)
Total Weighted Health Score: 4.667
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 650.00, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: 740 PAVILION VIEW DRIVE,MATTHEWS,NC,28105 (35.1143, -80.694)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-03-30
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-03-30
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2020-01-31
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0324, Version: New
Description: Provide properly protected cooking facilities.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-07-07
Type: Fire Safety, Tag: 0222, Version: New
Description: Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2020-02-21
Type: Fire Safety, Tag: 0324, Version: New
Description: Provide properly protected cooking facilities.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2020-02-21
Type: Fire Safety, Tag: 0345, Version: New
Description: Have approved installation, maintenance and testing program for fire alarm systems.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2020-02-21