Lakebridge Health Care Center - Johnson City Nursing Home
General Information
UPDATEFederal Provider Number
445358
Provider Name
LAKEBRIDGE HEALTH CARE CENTER
Provider Address
115 WOODLAWN DRIVE
JOHNSON CITY, TN 37604
JOHNSON CITY, TN 37604
Provider Phone Number
(423) 975-0095
Provider SSA County
890
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
109
Number of Residents in Certified Beds
103
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LAKEBRIDGE MEDICAL INVESTORS, LLC
Date First Approved to Provide Medicare and Medicaid services
1995-09-26
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
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
1.92039
Reported LPN Staffing Hours per Resident per Day
0.78010
Reported RN Staffing Hours per Resident per Day
0.31262
Reported Licensed Staffing Hours per Resident per Day
1.09272
Reported Total Nurse Staffing Hours per Resident per Day
3.01311
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05534
Expected CNA Staffing Hours per Resident per Day
2.43419
Expected LPN Staffing Hours per Resident per Day
0.64185
Expected RN Staffing Hours per Resident per Day
1.08268
Expected Total Nurse Staffing Hours per Resident per Day
4.15872
Adjusted CNA Staffing Hours per Resident per Day
1.93578
Adjusted LPN Staffing Hours per Resident per Day
1.00877
Adjusted RN Staffing Hours per Resident per Day
0.21575
Adjusted Total Nurse Staffing Hours per Resident per Day
2.92050
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-07-30
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-07-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2011-12-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
12.66700
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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