Creekside Health And Rehabilitation Center - Madison Nursing Home
General Information
UPDATEFederal Provider Number
445516
Provider Name
CREEKSIDE HEALTH AND REHABILITATION CENTER
Provider Address
306 W DUE WEST AVE
MADISON, TN 37115
MADISON, TN 37115
Provider Phone Number
6156124499
Provider SSA County
180
Provider County Name
Davidson
Ownership Type
For profit - Partnership
Number of Certified Beds
142
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CREEKSIDE HEALTHCARE, LLC
Date First Approved to Provide Medicare and Medicaid services
2014-01-15
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.17747
Reported LPN Staffing Hours per Resident per Day
0.94451
Reported RN Staffing Hours per Resident per Day
0.75165
Reported Licensed Staffing Hours per Resident per Day
1.69615
Reported Total Nurse Staffing Hours per Resident per Day
3.87363
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12967
Expected CNA Staffing Hours per Resident per Day
2.40543
Expected LPN Staffing Hours per Resident per Day
0.63243
Expected RN Staffing Hours per Resident per Day
1.10143
Expected Total Nurse Staffing Hours per Resident per Day
4.13930
Adjusted CNA Staffing Hours per Resident per Day
2.22116
Adjusted LPN Staffing Hours per Resident per Day
1.23957
Adjusted RN Staffing Hours per Resident per Day
0.50991
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77219
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
20
Cycle 1 Standard Survey Health Date
2015-02-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-15
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
-0001-11-30
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
12.00000
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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