Huntsville Manor - Huntsville Nursing Home
General Information
UPDATEFederal Provider Number
445288
Provider Name
HUNTSVILLE MANOR
Provider Address
287 BAKER STREET
HUNTSVILLE, TN 37756
HUNTSVILLE, TN 37756
Provider Phone Number
(423) 663-3600
Provider SSA County
750
Provider County Name
Scott
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
96
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HUNTSVILLE NH OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1992-04-23
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
2.02857
Reported LPN Staffing Hours per Resident per Day
0.93429
Reported RN Staffing Hours per Resident per Day
0.39857
Reported Licensed Staffing Hours per Resident per Day
1.33286
Reported Total Nurse Staffing Hours per Resident per Day
3.36143
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05286
Expected CNA Staffing Hours per Resident per Day
2.44599
Expected LPN Staffing Hours per Resident per Day
0.66543
Expected RN Staffing Hours per Resident per Day
1.12092
Expected Total Nurse Staffing Hours per Resident per Day
4.23234
Adjusted CNA Staffing Hours per Resident per Day
2.03496
Adjusted LPN Staffing Hours per Resident per Day
1.16535
Adjusted RN Staffing Hours per Resident per Day
0.26569
Adjusted Total Nurse Staffing Hours per Resident per Day
3.20144
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
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-10-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
44
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
44
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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