Provider Name: WHITE OAK AT NORTH GROVE INC
Address: 290 N GROVE MEDICAL PARK DRIVE, SPARTANBURG, SC 29303
Phone: (864) 345-1700
County: Spartanburg (410)
Ownership Type: For profit - Corporation
Certified Beds: 132
Average Residents Per Day: 124. ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: WHITE OAK MANOR INC
First Approved Date: May 4, 2017
Affiliated Entity: WHITE OAK MANAGEMENT (564)
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: 4 ()
QM Rating: 5 ()
Long Stay QM Rating: 5 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.57511, LPN Staff Hours Per Day: 1.0868, RN Staff Hours Per Day: 0.4662, Licensed Staff Hours Per Day: 1.5531
Total Nurse Staff Hours Per Day, per resident: 4.12822
Weekend Nurse Staff Hours: 3.95506, Weekend RN Staff Hours: 0.2483
PT Staff Hours Per Day, per resident: 0.0661
Nurse Staff Turnover: 62.6, Nurse Turnover Note:
RN Turnover: 44.4, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.0015, Case Mix LPN Hours Per Day: 0.6818, Case Mix RN Hours Per Day: 0.3224
Adjusted Nurse Aide Hours Per Day, per resident: 2.62101, Adjusted LPN Hours Per Day: 1.1763, Adjusted RN Hours Per Day: 0.5448
Total Adjusted Nurse Hours Per Day, per resident: 4.32902
Adjusted Weekend Nurse Hours Per Day, per resident: 4.14744
Health Survey Dates and Scores: Cycle 1: 2022-05-04 (Score: 12), Cycle 2: 2020-09-03 (Score: 4), Cycle 3: 2019-01-31 (Score: 16)
Total Weighted Health Score: 10.000
Reported Incidents: 3, Substantiated Complaints: 0
Infection Control Citations: 0
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 290 N GROVE MEDICAL PARK DRIVE,SPARTANBURG,SC,29303 (34.9465, -81.935)
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 each resident receives an accurate assessment.
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 2022-06-04
Type: Health, Deficiency: Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
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 2022-06-04
Type: Health, Deficiency: Respond appropriately to all alleged violations.
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 2022-06-04
Type: Health, Deficiency: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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 2022-12-06
Type: Health, Deficiency: Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
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 2019-03-02
Type: Health, Deficiency: Assess the resident when there is a significant change in condition
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 2019-03-02
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 2019-03-02
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: 0223, Version: New
Description: Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
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 2022-06-04
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 2022-06-04