Hosanna Health and Rehab of Piedmont
109 Bentz Road, Piedmont, SC 29673


Hosanna Health and Rehab of Piedmont is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 425314. The address is 109 Bentz Road, Piedmont, SC 29673. The zip code is 29673. The phone number is 8648455177.


Hosanna Health and Rehab of Piedmont · 109 Bentz Road, Piedmont, SC 29673

Federal Provider Number 425314
Provider Name HOSANNA HEALTH AND REHAB OF PIEDMONT
Address 109 BENTZ ROAD
PIEDMONT, SC 29673
Phone Number 8648455177
SSA County Code 220
County Name Greenville
Ownership Type For profit - Corporation
Certified Beds 88
Certified Beds Residents 80
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name SOUTHERN OAKS REHABILITATION AND HEALTHCARE CENTER, LLC
Date First Approved to Provide Medicare Medicaid Services 10/03/1991
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 1
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.6075
Reported LPN Staffing Hours per Resident per Day 0.90625
Reported RN Staffing Hours per Resident per Day 1.0925
Reported Licensed Staffing Hours per Resident per Day 1.99875
Reported Total Nurse Staffing Hours per Resident per Day 4.60625
Reported Physical Therapist Staffing Hours per Resident Per Day 0.12688
Expected CNA Staffing Hours per Resident per Day 2.55668
Expected LPN Staffing Hours per Resident per Day 0.66122
Expected RN Staffing Hours per Resident per Day 1.16382
Expected Total Nurse Staffing Hours per Resident per Day 4.38173
Adjusted CNA Staffing Hours per Resident per Day 2.50247
Adjusted LPN Staffing Hours per Resident per Day 1.13757
Adjusted RN Staffing Hours per Resident per Day 0.70141
Adjusted Total Nurse Staffing Hours per Resident per Day 4.23744
Cycle 1 Total Number of Health Deficiencies 10
Cycle 1 Number of Standard Health Deficiencies 10
Cycle 1 Health Deficiency Score 164
Cycle 1 Standard Survey Health Date 12/14/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 164
Cycle 2 Total Number of Health Deficiencies 4
Cycle 2 Number of Standard Health Deficiencies 4
Cycle 2 Health Deficiency Score 24
Cycle 2 Standard Health Survey Date 08/13/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 24
Cycle 3 Total Number of Health Deficiencies 6
Cycle 3 Number of Standard Health Deficiencies 6
Cycle 3 Health Deficiency Score 32
Cycle 3 Standard Health Survey Date 06/04/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 32
Total Weighted Health Survey Score 95.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Hosanna Health and Rehab of Piedmont

Owner Name Role Association Date
4 WEST HOLDINGS (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/27/2013
4 WEST INVESTORS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/27/2013
BOTTER, JENNIFER (Individual) OFFICER since 09/01/2015
DES NEW ARK TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/27/2013
FARTHING, SHANNON (Individual) MANAGING EMPLOYEE since 07/11/2016
HS NEW ARK TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/27/2013
JS NEW ARK TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/27/2013
ORIANNA SC OPERATOR HOLDINGS INC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 11/27/2013
ROBINSON, CRAIG (Individual) OFFICER since 09/01/2015

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