Provider Name: FAIR HAVEN HOME INC
Address: 149 FAIR HAVEN DRIVE, BOSTIC, NC 28018
Phone: (828) 245-9095
County: Rutherford (800)
Ownership Type: For profit - Corporation
Certified Beds: 30
Average Residents Per Day: 27.8 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: FAIR HAVEN HOME, INC.
First Approved Date: June 25, 1992
Affiliated Entity: ()
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: 3 ()
Long Stay QM Rating: 2 ()
Short Stay QM Rating: 4 ()
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 1.81740, LPN Staff Hours Per Day: 1.3265, RN Staff Hours Per Day: 0.8003, Licensed Staff Hours Per Day: 2.1269
Total Nurse Staff Hours Per Day, per resident: 3.94431
Weekend Nurse Staff Hours: 2.94648, Weekend RN Staff Hours: 0.4381
PT Staff Hours Per Day, per resident: 0.0015
Nurse Staff Turnover: 43.2, Nurse Turnover Note:
RN Turnover: 20.0, RN Turnover Note:
Admin Left Number: , Admin Turnover Note: 6
Case Mix Nurse Aide Hours Per Day, per resident: 2.0586, Case Mix LPN Hours Per Day: 0.7080, Case Mix RN Hours Per Day: 0.3673
Adjusted Nurse Aide Hours Per Day, per resident: 1.79855, Adjusted LPN Hours Per Day: 1.3825, Adjusted RN Hours Per Day: 0.8210
Total Adjusted Nurse Hours Per Day, per resident: 3.96699
Adjusted Weekend Nurse Hours Per Day, per resident: 2.96342
Health Survey Dates and Scores: Cycle 1: 2023-01-04 (Score: 4), Cycle 2: 2021-01-22 (Score: 4), Cycle 3: 2019-06-13 (Score: 0)
Total Weighted Health Score: 3.333
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 28600.00, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: 149 FAIR HAVEN DRIVE,BOSTIC,NC,28018 (35.3379, -81.807)
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 that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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 2023-01-25
Type: Health, Deficiency: Allow residents to self-administer drugs if determined clinically appropriate.
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 2021-02-01
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: 0353, Version: New
Description: Inspect, test, and maintain automatic sprinkler systems.
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 2023-02-17
Type: Fire Safety, Tag: 0211, Version: New
Description: Keep aisles, corridors, and exits free of obstruction in case of emergency.
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 2019-08-15
Type: Fire Safety, Tag: 0345, Version: New
Description: Have approved installation, maintenance and testing program for fire alarm systems.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-08-15
Type: Fire Safety, Tag: 0372, Version: New
Description: Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
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 2019-08-15
Type: Fire Safety, Tag: 0918, Version: New
Description: Have generator or other power source capable of supplying service within 10 seconds.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-08-15