Tennessee Nursing Homes >> Dover Nursing Homes >> Manor House Of Dover

Manor House Of Dover - Dover Nursing Home

General Information

UPDATE
Federal Provider Number
445155
Provider Name
MANOR HOUSE OF DOVER
Provider Address
537 SPRING STREET, PO BOX 399
DOVER, TN 37058
Provider Phone Number
9312326902
Provider SSA County
800
Provider County Name
Stewart
Ownership Type
For profit - Corporation
Number of Certified Beds
88
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DIVERSICARE LEASING CORP.
Date First Approved to Provide Medicare and Medicaid services
1983-01-04
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.16833
Reported LPN Staffing Hours per Resident per Day
0.76917
Reported RN Staffing Hours per Resident per Day
0.49917
Reported Licensed Staffing Hours per Resident per Day
1.26833
Reported Total Nurse Staffing Hours per Resident per Day
3.43667
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09500
Expected CNA Staffing Hours per Resident per Day
2.54838
Expected LPN Staffing Hours per Resident per Day
0.64667
Expected RN Staffing Hours per Resident per Day
0.99185
Expected Total Nurse Staffing Hours per Resident per Day
4.18690
Adjusted CNA Staffing Hours per Resident per Day
2.08777
Adjusted LPN Staffing Hours per Resident per Day
0.98723
Adjusted RN Staffing Hours per Resident per Day
0.37604
Adjusted Total Nurse Staffing Hours per Resident per Day
3.30862
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-02-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2011-12-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2010-10-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
25.33300
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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