Life Care Center Of Hickory Woods - Antioch Nursing Home
General Information
UPDATEFederal Provider Number
445507
Provider Name
LIFE CARE CENTER OF HICKORY WOODS
Provider Address
4200 MURFREESBORO PIKE
ANTIOCH, TN 37013
ANTIOCH, TN 37013
Provider Phone Number
(615) 501-3500
Provider SSA County
180
Provider County Name
Davidson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
124
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HIGHLAND PARK MEDICAL INVESTORS, LLC
Date First Approved to Provide Medicare and Medicaid services
2011-11-30
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
2.44714
Reported LPN Staffing Hours per Resident per Day
1.44786
Reported RN Staffing Hours per Resident per Day
1.44929
Reported Licensed Staffing Hours per Resident per Day
2.89714
Reported Total Nurse Staffing Hours per Resident per Day
5.34429
Reported Physical Therapist Staffing Hours per Resident Per Day
0.70143
Expected CNA Staffing Hours per Resident per Day
2.24106
Expected LPN Staffing Hours per Resident per Day
0.76592
Expected RN Staffing Hours per Resident per Day
1.61118
Expected Total Nurse Staffing Hours per Resident per Day
4.61817
Adjusted CNA Staffing Hours per Resident per Day
2.67933
Adjusted LPN Staffing Hours per Resident per Day
1.56899
Adjusted RN Staffing Hours per Resident per Day
0.67212
Adjusted Total Nurse Staffing Hours per Resident per Day
4.66469
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2013-11-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
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
2011-11-30
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
26.40000
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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