Provider Name: ARBOR ACRES UNITED METHODIST RETIREMENT COMMUNITY
Address: 1250 ARBOR ROAD, WINSTON SALEM, NC 27104
Phone: (336) 724-7921
County: Forsyth (330)
Ownership Type: Non profit - Corporation
Certified Beds: 6
Average Residents Per Day: 4.3 ()
Provider Type: Medicare, Resides in Hospital: No
Legal Business Name: ARBOR ACRES UNITED METHODIST RETIREMENT COMMUNITY INC
First Approved Date: June 30, 2017
Affiliated Entity: ()
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: 4 ()
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: 4.04497, LPN Staff Hours Per Day: 2.2757, RN Staff Hours Per Day: 0.5880, Licensed Staff Hours Per Day: 2.8638
Total Nurse Staff Hours Per Day, per resident: 6.90879
Weekend Nurse Staff Hours: 6.43051, Weekend RN Staff Hours: 0.2305
PT Staff Hours Per Day, per resident: 0.2262
Nurse Staff Turnover: 55.6, Nurse Turnover Note:
RN Turnover: , RN Turnover Note: 6
Admin Left Number: , Admin Turnover Note: 6
Case Mix Nurse Aide Hours Per Day, per resident: 2.2797, Case Mix LPN Hours Per Day: 0.9683, Case Mix RN Hours Per Day: 0.5972
Adjusted Nurse Aide Hours Per Day, per resident: 3.61474, Adjusted LPN Hours Per Day: 1.7343, Adjusted RN Hours Per Day: 0.3710
Total Adjusted Nurse Hours Per Day, per resident: 5.66321
Adjusted Weekend Nurse Hours Per Day, per resident: 5.27116
Health Survey Dates and Scores: Cycle 1: 2023-11-09 (Score: 0), Cycle 2: 2022-11-09 (Score: 4), Cycle 3: 2021-02-25 (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: 1300.00, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: 1250 ARBOR ROAD,WINSTON SALEM,NC,27104 (36.1067, -80.279)
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: Develop and implement policies and procedures for flu and pneumonia vaccinations.
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 2022-12-17
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: 0321, Version: New
Description: Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
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 2024-01-30
Type: Fire Safety, Tag: 0324, Version: New
Description: Provide properly protected cooking facilities.
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 2024-01-30
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 2024-01-30
Type: Fire Safety, Tag: 0363, Version: New
Description: Install corridor and hallway doors that block smoke.
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 2024-01-30
Type: Fire Safety, Tag: 0521, Version: New
Description: Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
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 2024-01-30
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 2024-01-30
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 2022-12-29