Life Care Center Of Gray - Gray Nursing Home
General Information
UPDATEFederal Provider Number
445479
Provider Name
LIFE CARE CENTER OF GRAY
Provider Address
791 OLD GRAY STATION ROAD
GRAY, TN 37615
GRAY, TN 37615
Provider Phone Number
(423) 477-7146
Provider SSA County
890
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
133
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GRAY MEDICAL INVESTORS, LLC
Date First Approved to Provide Medicare and Medicaid services
2005-04-24
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
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.67500
Reported LPN Staffing Hours per Resident per Day
1.24800
Reported RN Staffing Hours per Resident per Day
0.78800
Reported Licensed Staffing Hours per Resident per Day
2.03600
Reported Total Nurse Staffing Hours per Resident per Day
3.71100
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13300
Expected CNA Staffing Hours per Resident per Day
2.46219
Expected LPN Staffing Hours per Resident per Day
0.59561
Expected RN Staffing Hours per Resident per Day
0.95702
Expected Total Nurse Staffing Hours per Resident per Day
4.01481
Adjusted CNA Staffing Hours per Resident per Day
1.66923
Adjusted LPN Staffing Hours per Resident per Day
1.73914
Adjusted RN Staffing Hours per Resident per Day
0.61523
Adjusted Total Nurse Staffing Hours per Resident per Day
3.72587
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-09-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-08-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
40
Cycle 3 Standard Health Survey Date
2012-01-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
20.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
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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