Provider Name: WILLOWBROOKE COURT SC CTR AT TRYON ESTATES
Address: 619 LAUREL LAKE DRIVE, COLUMBUS, NC 28722
Phone: (828) 894-5500
County: Polk (740)
Ownership Type: Non profit - Corporation
Certified Beds: 33
Average Residents Per Day: 22.1 ()
Provider Type: Medicare, Resides in Hospital: No
Legal Business Name: ACTS RETIREMENT-LIFE COMMUNITIES INC
First Approved Date: June 3, 1994
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: 3 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.21366, LPN Staff Hours Per Day: 0.9036, RN Staff Hours Per Day: 0.9787, Licensed Staff Hours Per Day: 1.8824
Total Nurse Staff Hours Per Day, per resident: 4.09606
Weekend Nurse Staff Hours: 3.43971, Weekend RN Staff Hours: 0.4380
PT Staff Hours Per Day, per resident: 0.1013
Nurse Staff Turnover: 32.4, Nurse Turnover Note:
RN Turnover: 37.5, RN Turnover Note:
Admin Left Number: 1, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 1.9836, Case Mix LPN Hours Per Day: 0.6251, Case Mix RN Hours Per Day: 0.2778
Adjusted Nurse Aide Hours Per Day, per resident: 2.27350, Adjusted LPN Hours Per Day: 1.0666, Adjusted RN Hours Per Day: 1.3273
Total Adjusted Nurse Hours Per Day, per resident: 4.47263
Adjusted Weekend Nurse Hours Per Day, per resident: 3.75594
Health Survey Dates and Scores: Cycle 1: 2023-09-08 (Score: 0), Cycle 2: 2022-04-07 (Score: 4), Cycle 3: 2019-08-01 (Score: 0)
Total Weighted Health Score: 1.333
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: 619 LAUREL LAKE DRIVE,COLUMBUS,NC,28722 (35.2323, -82.201)
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 2022-05-05
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: 0911, Version: New
Description: Meet requirements for the installation and maintenance of electrical 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 2023-11-10
Type: Fire Safety, Tag: 0372, Version: New
Description: Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
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 2019-09-10