Ave Maria Home - Bartlett Nursing Home
General Information
UPDATEFederal Provider Number
445490
Provider Name
AVE MARIA HOME
Provider Address
2805 CHARLES BRYAN RD
BARTLETT, TN 38134
BARTLETT, TN 38134
Provider Phone Number
9013863211
Provider SSA County
780
Provider County Name
Shelby
Ownership Type
Non profit - Corporation
Number of Certified Beds
75
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AVE MARIA HOME
Date First Approved to Provide Medicare and Medicaid services
2009-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
3.72681
Reported LPN Staffing Hours per Resident per Day
0.99420
Reported RN Staffing Hours per Resident per Day
0.39348
Reported Licensed Staffing Hours per Resident per Day
1.38768
Reported Total Nurse Staffing Hours per Resident per Day
5.11449
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.55267
Expected LPN Staffing Hours per Resident per Day
0.58612
Expected RN Staffing Hours per Resident per Day
0.92164
Expected Total Nurse Staffing Hours per Resident per Day
4.06043
Adjusted CNA Staffing Hours per Resident per Day
3.58232
Adjusted LPN Staffing Hours per Resident per Day
1.40787
Adjusted RN Staffing Hours per Resident per Day
0.31901
Adjusted Total Nurse Staffing Hours per Resident per Day
5.07729
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-11-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-08-21
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-06-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
11.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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