Provider Name: PINEY GROVE NURSING AND REHABILITATION CENTER
Address: 728 PINEY GROVE ROAD, KERNERSVILLE, NC 27284
Phone: (336) 996-4038
County: Forsyth (330)
Ownership Type: For profit - Corporation
Certified Beds: 92
Average Residents Per Day: 78.2 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: SNOWSHOE LTC GROUP, LLC
First Approved Date: March 7, 1991
Affiliated Entity: PRINCIPLE LONG TERM CARE (423)
Retirement Community: N, 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: 5 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 2 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.13959, LPN Staff Hours Per Day: 0.9429, RN Staff Hours Per Day: 0.5465, Licensed Staff Hours Per Day: 1.4894
Total Nurse Staff Hours Per Day, per resident: 3.62906
Weekend Nurse Staff Hours: 3.24728, Weekend RN Staff Hours: 0.2980
PT Staff Hours Per Day, per resident: 0.0593
Nurse Staff Turnover: 73.1, Nurse Turnover Note:
RN Turnover: 62.5, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.1125, Case Mix LPN Hours Per Day: 0.8153, Case Mix RN Hours Per Day: 0.4433
Adjusted Nurse Aide Hours Per Day, per resident: 2.06336, Adjusted LPN Hours Per Day: 0.8534, Adjusted RN Hours Per Day: 0.4644
Total Adjusted Nurse Hours Per Day, per resident: 3.39310
Adjusted Weekend Nurse Hours Per Day, per resident: 3.03614
Health Survey Dates and Scores: Cycle 1: 2023-06-08 (Score: 0), Cycle 2: 2022-02-24 (Score: 8), Cycle 3: 2019-10-25 (Score: 4)
Total Weighted Health Score: 3.333
Reported Incidents: 0, Substantiated Complaints: 1
Infection Control Citations:
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 728 PINEY GROVE ROAD,KERNERSVILLE,NC,27284 (36.1356, -80.071)
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: Provide activities to meet all resident's needs.
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 2022-03-24
Type: Health, Deficiency: Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
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 2022-03-24
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 2019-11-22
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: 0712, Version: New
Description: Have simulated fire drills held at unexpected times.
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 2023-08-05
Type: Fire Safety, Tag: 0918, Version: New
Description: Have generator or other power source capable of supplying service within 10 seconds.
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 2023-08-05
Type: Fire Safety, Tag: 0271, Version: New
Description: Have exits that are accessible at all times.
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 2019-12-21
Type: Fire Safety, Tag: 0918, Version: New
Description: Have generator or other power source capable of supplying service within 10 seconds.
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 2019-12-21
Type: Fire Safety, Tag: 0923, Version: New
Description: Have proper medical gas storage and administration areas.
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 2019-12-21