Signature Healthcare Of Fentress County - Jamestown Nursing Home
General Information
UPDATEFederal Provider Number
445362
Provider Name
SIGNATURE HEALTHCARE OF FENTRESS COUNTY
Provider Address
208 DUNCAN ST N
JAMESTOWN, TN 38556
JAMESTOWN, TN 38556
Provider Phone Number
9318795859
Provider SSA County
240
Provider County Name
Fentress
Ownership Type
For profit - Corporation
Number of Certified Beds
140
Number of Residents in Certified Beds
87
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1996-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.11437
Reported LPN Staffing Hours per Resident per Day
1.23621
Reported RN Staffing Hours per Resident per Day
0.84540
Reported Licensed Staffing Hours per Resident per Day
2.08161
Reported Total Nurse Staffing Hours per Resident per Day
4.19598
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13851
Expected CNA Staffing Hours per Resident per Day
2.71872
Expected LPN Staffing Hours per Resident per Day
0.68648
Expected RN Staffing Hours per Resident per Day
1.15356
Expected Total Nurse Staffing Hours per Resident per Day
4.55876
Adjusted CNA Staffing Hours per Resident per Day
1.90826
Adjusted LPN Staffing Hours per Resident per Day
1.49466
Adjusted RN Staffing Hours per Resident per Day
0.54760
Adjusted Total Nurse Staffing Hours per Resident per Day
3.71012
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2015-04-29
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-02-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
19
Cycle 3 Number of Standard Health Deficiencies
19
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
180
Cycle 3 Standard Health Survey Date
2012-08-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
180
Total Weighted Health Survey Score
61.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
7
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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