PENDER MEMORIAL HOSP SNF - BURGAW, NC

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Addresss:

507 FREMONT STREET
BURGAW, NC, 28425

Phone (make sure to verify first before calling): (910) 259-5451

Number of Certified Beds: 43
Total Number of Residents: 38
Percent of Occupied Beds: 88%
Sprinkler Status: Fully Sprinklered
Program Participation: Medicare and Medicaid
Type of Ownership: Non profit - Other
Located Within a Hospital?: Yes
Multi Nursing Home Ownership?: No
Resident and Family Councils: Resident
Continuing Care Retirement Community?: No
Quality Indicator Survey?: No
Special Focus Facility?: No
Type: Skilled Nursing Facilities

Overall Star Rating: 2 Stars
Health Inspections Star Rating: 2 Stars
Nurse Staffing Star Rating: 3 Stars
Quality Measures Star Rating: 3 Stars
RN Only Star Rating: 3 Stars

Other nearby nursing homes

BRIAN CTR HLTH AND REHABILITATIO (WALLACE, 12.83 miles)
NORTHCHASE NURSING AND REHABILITATION CENTER (WILMINGTON, 17.06 miles)
CAPE FEAR DIALYSIS (WILMINGTON, 17.07 miles)
DAVIS HEALTH CARE CENTER (WILMINGTON, 20.08 miles)
HUNTINGTON HEALTH CARE (0.68 miles)
SOUTHEASTERN DIALYSIS BURGAW (0.51 miles)
WOODBURY WELLNESS CENTER INC (HAMPSTEAD, 19.43 miles)

Employment Full-Time Equivalent

Administrative Staff - Full Time: 1.14

Administrative Staff - Part Time: 0.80

Certified Nurse Aides - Full Time: 8.61

Certified Nurse Aides - Part Time: 2.96

Dietitians - Under Contract: 0.11

Food Service Personnel - Full Time: 4.67

Food Service Personnel - Part Time: 4.31

Housekeeping Personnel - Full Time: 1.09

Licensed Practical/ Vocational Nurses - Part Time: 6.07

Nurses With Administrative Duties - Full Time: 1.19

Registered Nurses - Full Time: 2.24

Rn Director Of Nursing - Full Time: 1.14

Social Workers - Full Time: 1.00

Occupational Therapists - Part Time: 0.77

Physical Therapists - Part Time: 0.60

Administrative Staff - Under Contract: 2.29

Registered Nurses - Part Time: 2.04

Housekeeping Personnel - Part Time: 0.46

Pharmacists - Full Time: 1.03

Occupational Therapy Assistants - Part Time: 0.70

Pharmacists - Part Time: 0.46

Physical Therapy Aide - Part Time: 0.86

Medication Aides/ Technicians - Part Time: 4.76

Medication Aides/ Technicians - Full Time: 1.13

Number Of Beds

Total: 43

Total Certified: 43

Provided Services

Administration And Storage Of Blood Services Are Provided Onsite To Nonresidents

Administration And Storage Of Blood Services Are Provided Onsite To Residents

Clinical Laboratory Services Are Provided Offsite To Residents

Clinical Laboratory Services Are Provided Onsite To Non Residents

Clinical Laboratory Services Are Provided Onsite To Residents

Dental Services Are Provided Offsite To Residents

Diagnostic Xray Services Are Provided Onsite To Non Residents

Diagnostic Xray Services Are Provided Onsite To Residents

Dietary Services Are Provided Onsite To Non Residents

Dietary Services Are Provided Onsite To Residents

Housekeeping Services Are Provided Onsite To Non Residents

Housekeeping Services Are Provided Onsite To Residents

Mental Health Services Are Provided Offsite To Residents

Nursing Services Are Provided Onsite To Residents

Occupational Therapy Services Are Provided Offsite To Residents

Occupational Therapy Services Are Provided Onsite To Non Residents

Occupational Therapy Services Are Provided Onsite To Residents

Other Social Services Are Provided Onsite To Nonresidents

Pharmacy Services Are Provided Onsite To Non Residents

Pharmacy Services Are Provided Onsite To Residents

Physical Therapy Services Are Provided Offsite To Residents

Physical Therapy Services Are Provided Onsite To Non Residents

Physical Therapy Services Are Provided Onsite To Residents

Physician Services Are Provided Onsite To Non Residents

Physician Services Are Provided Onsite To Residents

Podiatry Services Are Provided Offsite To Residents

Social Work Services Are Provided Onsite To Non Residents

Social Work Services Are Provided Onsite To Residents

Speech/Language Pathology Services Are Provided Onsite To Non Residents

Speech/Language Pathology Services Are Provided Onsite To Residents

Therapeutic Recreation Specialist Services Are Provided Onsite To Residents

Staff Information

Number of Registered Nurses Hours Per Resident Per Day

This Nursing Home:	0.700
North Carolina:	0.671

Number of Licensed Practical and Licensed Vocational Nurses Hours Per Resident Per Day

Here:	0.870
State:	0.848

Total Number of Licensed Staff Hours Per Resident Per Day

Here:	1.560
State:	1.518

Number of ,Certified Nurse Assistant Hours Per Resident Per Day

Here:	0.070
North Carolina:	0.086

Number Therapy Hours Per Resident Per Day

Here:	0.070
North Carolina:	0.088

Quality Measures

Percent of long-stay high-risk residents with pressure ulcers

Here:	6.7%
State:	7.4%

Percent of long-stay residents who lose too much weight

Here:	9.1%
North Carolina:	8.7%

Percent of long-stay residents who have had a catheter inserted and left in their bladder

Here:	6.4%
State:	3.2%

Percent of long-stay residents with a urinary tract infection

Here:	8.8%
State:	8.1%

Percent of long-stay residents experiencing one or more falls with major injury

Here:	5.9%
State:	3.2%

Percent of long-stay residents assessed and given, appropriately, the seasonal influenza vaccine

This Nursing Home:	97.1%
North Carolina:	94.9%

Percent of long-stay residents assessed and given, appropriately, the pneumococcal vaccine

Here:	97.1%
North Carolina:	96.5%

Percent of long-stay residents who received an antipsychotic medication

Here:	12.1%
State:	21.0%

Complaint Deficiency

Provide medically-related social services to help each resident achieve the highest possible quality of life
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Hire a qualified full-time social worker in a facility with more than 120 beds
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Make sure services provided by the nursing facility meet professional standards of quality
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Corridor and hallway doors that block smoke
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Exits that are accessible at all times
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Proper backup exit lighting
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Properly installed electrical wiring and equipment
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Immediately tell the resident, the resident's doctor and a family member of the resident of situations (injury/decline/room, etc.) that affect the resident
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Conduct initial and periodic assessments of each resident's functional capacity
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Completely assess the resident at least every twelve months
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Check and assess each resident's assessment at least every 3 months
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Make sure services provided by the nursing facility meet professional standards of quality
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Maintain 15 months of resident assessments in the resident's active clinical record
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Encode and automate the resident's assessment data
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Make sure that each resident gets a nutritional and well balanced diet, unless it is not possible to do so
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Be administered in an acceptable way that maintains the well-being of each resident
- Harm: Minimal harm or potential for actual harm
- Scope: Some
Exits that are accessible at all times
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Properly working alarms on sprinkler valves
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Immediately tell the resident, the resident's doctor and a family member of the resident of situations (injury/decline/room, etc.) that affect the resident
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Determine if it is safe for the resident to self-administer drugs
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured
- Harm: Minimal harm or potential for actual harm
- Scope: Few
1) Make sure that each resident's drug regimen is free from unnecessary drugs; 2) Each resident's entire drug/medication is managed and monitored to achieve highest well being
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Safely provide drugs and other similar products available, which are needed every day and in emergencies, by a licensed pharmacist
- Harm: Minimal harm or potential for actual harm
- Scope: Few
At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor
- Harm: Minimal harm or potential for actual harm
- Scope: Few
Construction that can resist fire for one hour or an approved fire extinguishing system
- Harm: Minimal harm or potential for actual harm
- Scope: Few

Process of Care

Pneumonia

Percent of Patients Given Initial Antibiotic(s) within 6 Hours After Arrival

Here:	100.0%
State:	95.8%

Percent of Patients Whose Initial ER Blood Culture Was Performed Prior To Administration Of First Dose Of Antibiotics

Here:	100.0%
North Carolina:	96.7%

Percent of Patients Given the Most Appropriate Initial Antibiotic(s)

This Nursing Home:	92.0%
North Carolina:	95.8%

Percent of Patients Assessed and Given Influenza Vaccination

Here:	83.0%
North Carolina:	95.4%

Percent of Patients Assessed and Given Pneumococcal Vaccination

Here:	75.0%
North Carolina:	97.2%

Surgery

Percent of Surgery Patients given an antibiotic at the right time (within one hour before surgery) to help prevent infection

Here:	100.0%
North Carolina:	98.8%

Percent of Surgery Patients whose preventive antibiotics were stopped at the right time (within 24 hours after surgery)

This Nursing Home:	100.0%
North Carolina:	97.7%

Percent of Surgery Patients who were given the right kind of antibiotic to help prevent infection

Here:	100.0%
North Carolina:	99.0%

Percent of Surgery Patients needing hair removed from the surgical area before surgery who had hair removed using a safer method

Here:	100.0%
State:	99.9%

Patients having surgery who were actively warmed in the operating room or whose body temperature was near normal

This Nursing Home:	100.0%
North Carolina:	99.8%

Outcome of Care

30-Day Mortality Rates from Heart Failure

Here:	12.0%
North Carolina:	11.5%

30-Day Mortality Rates from Pneumonia

This Nursing Home:	13.6%
State:	12.5%

30-Day Readmission Rates from Heart Failure

This Nursing Home:	25.3%
State:	24.1%

30-Day Readmission Rates from Pneumonia

This Nursing Home:	19.8%
State:	18.8%