Humphreys Co Nursing Home - Waverly Nursing Home
General Information
UPDATEFederal Provider Number
445489
Provider Name
HUMPHREYS CO NURSING HOME
Provider Address
670 HIGHWAY 13 SOUTH
WAVERLY, TN 37185
WAVERLY, TN 37185
Provider Phone Number
9312962532
Provider SSA County
420
Provider County Name
Humphreys
Ownership Type
Non profit - Corporation
Number of Certified Beds
66
Number of Residents in Certified Beds
63
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HUMPHREYS COUNTY NURSING 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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
3.17063
Reported LPN Staffing Hours per Resident per Day
1.00952
Reported RN Staffing Hours per Resident per Day
0.52857
Reported Licensed Staffing Hours per Resident per Day
1.53810
Reported Total Nurse Staffing Hours per Resident per Day
4.70872
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09048
Expected CNA Staffing Hours per Resident per Day
2.76086
Expected LPN Staffing Hours per Resident per Day
0.63032
Expected RN Staffing Hours per Resident per Day
0.86994
Expected Total Nurse Staffing Hours per Resident per Day
4.26112
Adjusted CNA Staffing Hours per Resident per Day
2.81788
Adjusted LPN Staffing Hours per Resident per Day
1.32932
Adjusted RN Staffing Hours per Resident per Day
0.45399
Adjusted Total Nurse Staffing Hours per Resident per Day
4.45431
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-11-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
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
2013-08-13
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-05-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
9.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
4388
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Waverly Health Care & Rehabilitation Center
895 Powers Blvd |
WAVERLY TN 37185 | 5.2 miles away
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