Asbury Place At Kingsport - Kingsport Nursing Home
General Information
UPDATEFederal Provider Number
445481
Provider Name
ASBURY PLACE AT KINGSPORT
Provider Address
100 NETHERLAND LANE
KINGSPORT, TN 37660
KINGSPORT, TN 37660
Provider Phone Number
(423) 245-0360
Provider SSA County
810
Provider County Name
Sullivan
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
67
Number of Residents in Certified Beds
63
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
ASBURY, INC.
Date First Approved to Provide Medicare and Medicaid services
2005-12-08
Continuing Care Retirement Community
Y
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.56111
Reported LPN Staffing Hours per Resident per Day
1.16587
Reported RN Staffing Hours per Resident per Day
0.64683
Reported Licensed Staffing Hours per Resident per Day
1.81270
Reported Total Nurse Staffing Hours per Resident per Day
4.37381
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16984
Expected CNA Staffing Hours per Resident per Day
2.53015
Expected LPN Staffing Hours per Resident per Day
0.71851
Expected RN Staffing Hours per Resident per Day
1.41686
Expected Total Nurse Staffing Hours per Resident per Day
4.66552
Adjusted CNA Staffing Hours per Resident per Day
2.48372
Adjusted LPN Staffing Hours per Resident per Day
1.34677
Adjusted RN Staffing Hours per Resident per Day
0.34111
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77887
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-11-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-10-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-09-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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