Bledsoe County Nursing Home - Pikeville Nursing Home
General Information
UPDATEFederal Provider Number
440000000000000000000000000000
Provider Name
BLEDSOE COUNTY NURSING HOME
Provider Address
107 WHEELERTOWN AVENUE
PIKEVILLE, TN 37367
PIKEVILLE, TN 37367
Provider Phone Number
4234476811
Provider SSA County
30
Provider County Name
Bledsoe
Ownership Type
Government - County
Number of Certified Beds
50
Number of Residents in Certified Beds
43
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1978-05-31
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
1
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.93140
Reported LPN Staffing Hours per Resident per Day
0.97093
Reported RN Staffing Hours per Resident per Day
0.31977
Reported Licensed Staffing Hours per Resident per Day
1.29070
Reported Total Nurse Staffing Hours per Resident per Day
3.22210
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00465
Expected CNA Staffing Hours per Resident per Day
2.56418
Expected LPN Staffing Hours per Resident per Day
0.73623
Expected RN Staffing Hours per Resident per Day
1.03007
Expected Total Nurse Staffing Hours per Resident per Day
4.33048
Adjusted CNA Staffing Hours per Resident per Day
1.84819
Adjusted LPN Staffing Hours per Resident per Day
1.09459
Adjusted RN Staffing Hours per Resident per Day
0.23196
Adjusted Total Nurse Staffing Hours per Resident per Day
2.99920
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-04-22
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-02-26
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
17
Cycle 3 Number of Standard Health Deficiencies
17
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
96
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
96
Total Weighted Health Survey Score
34.00000
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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