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PELICAN HEALTH RANDOLPH LLC

Overall Rating

Address

4801 Randolph Road

Charlotte, NC 28211

Contact

7043648363

Certification Date

1980-10-01

Details

CMS Certification Number

345134

Ownership Type

For profit - Partnership

Number of Certified Beds

100

Average Number of Residents per Day

68.6

Provider Type

Medicare and Medicaid

Legal Business Name

PELICAN HEALTH RANDOLPH LLC

Affiliated Entity Name

SIMCHA HYMAN & NAFTALI ZANZIPER

Affiliated Entity ID

580

Ratings

Health Inspection Rating

1

Quality Measure Rating

Staffing Rating

1

Staffing

Reported Nurse Aide Staffing Hours per Resident per Day

2.16908

Reported LPN Staffing Hours per Resident per Day

0.86731

Reported RN Staffing Hours per Resident per Day

0.39627

Reported Total Nurse Staffing Hours per Resident per Day

3.43266

Total Number of Nurse Staff Hours per Resident per Day on the Weekend

3.02926

Registered Nurse Hours per Resident per Day on the Weekend

0.33405

Reported Physical Therapist Staffing Hours per Resident Per Day

0.04385

Quality Measures

Long-Stay Quality Measure Rating

Short-Stay Quality Measure Rating

3

Inspections

Total Weighted Health Survey Score

115.333

Number of Facility Reported Incidents

0

Number of Substantiated Complaints

64

Number of Citations from Infection Control Inspections

0

Health Inspections

Rating Cycle 1

Standard Health Survey Date

2023-02-28

Total Number of Health Deficiencies

25

Number of Standard Health Deficiencies

21

Number of Complaint Health Deficiencies

25

Health Deficiency Score

120

Number of Health Revisits

2

Health Revisit Score

60

Total Health Score

180

Rating Cycle 2

Standard Health Survey Date

2021-11-22

Total Number of Health Deficiencies

7

Number of Standard Health Deficiencies

7

Number of Complaint Health Deficiencies

4

Health Deficiency Score

32

Number of Health Revisits

2

Health Revisit Score

16

Total Health Score

48

Rating Cycle 3

Standard Health Survey Date

2019-12-13

Total Number of Health Deficiencies

13

Number of Standard Health Deficiencies

3

Number of Complaint Health Deficiencies

10

Health Deficiency Score

56

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

56

Penalties

Number of Fines

2

Total Amount of Fines in Dollars

30325.75

Number of Payment Denials

1

Total Number of Penalties

3