Dove Health & Rehab Of Collierville, Llc - Collierville Nursing Home
General Information
UPDATEFederal Provider Number
445495
Provider Name
DOVE HEALTH & REHAB OF COLLIERVILLE, LLC
Provider Address
490 WEST POPLAR AVENUE
COLLIERVILLE, TN 38017
COLLIERVILLE, TN 38017
Provider Phone Number
9018548506
Provider SSA County
780
Provider County Name
Shelby
Ownership Type
For profit - Corporation
Number of Certified Beds
114
Number of Residents in Certified Beds
103
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DOVE HEALTH & REHAB OF COLLIERVILLE, LLC
Date First Approved to Provide Medicare and Medicaid services
2009-07-07
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
1
Health Inspection Rating Footnote
QM Rating
3
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
2.15194
Reported LPN Staffing Hours per Resident per Day
1.28932
Reported RN Staffing Hours per Resident per Day
0.67961
Reported Licensed Staffing Hours per Resident per Day
1.96893
Reported Total Nurse Staffing Hours per Resident per Day
4.12087
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04709
Expected CNA Staffing Hours per Resident per Day
2.45462
Expected LPN Staffing Hours per Resident per Day
0.65685
Expected RN Staffing Hours per Resident per Day
1.12691
Expected Total Nurse Staffing Hours per Resident per Day
4.23838
Adjusted CNA Staffing Hours per Resident per Day
2.15114
Adjusted LPN Staffing Hours per Resident per Day
1.62919
Adjusted RN Staffing Hours per Resident per Day
0.45062
Adjusted Total Nurse Staffing Hours per Resident per Day
3.91914
Cycle 1 Total Number of Health Deficiencies
20
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-07-03
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
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
148
Cycle 3 Standard Health Survey Date
2011-07-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
148
Total Weighted Health Survey Score
91.33300
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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