Mountain City Care & Rehabilitation Center - Mountain City Nursing Home
General Information
UPDATEFederal Provider Number
445214
Provider Name
MOUNTAIN CITY CARE & REHABILITATION CENTER
Provider Address
919 MEDICAL PARK DRIVE
MOUNTAIN CITY, TN 37683
MOUNTAIN CITY, TN 37683
Provider Phone Number
4237277800
Provider SSA County
450
Provider County Name
Johnson
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
109
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP MOUNTAIN CITY LLC
Date First Approved to Provide Medicare and Medicaid services
1988-12-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
2.07477
Reported LPN Staffing Hours per Resident per Day
0.93899
Reported RN Staffing Hours per Resident per Day
0.42294
Reported Licensed Staffing Hours per Resident per Day
1.36193
Reported Total Nurse Staffing Hours per Resident per Day
3.43670
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04908
Expected CNA Staffing Hours per Resident per Day
2.43131
Expected LPN Staffing Hours per Resident per Day
0.66402
Expected RN Staffing Hours per Resident per Day
1.03142
Expected Total Nurse Staffing Hours per Resident per Day
4.12676
Adjusted CNA Staffing Hours per Resident per Day
2.09387
Adjusted LPN Staffing Hours per Resident per Day
1.17370
Adjusted RN Staffing Hours per Resident per Day
0.30639
Adjusted Total Nurse Staffing Hours per Resident per Day
3.35687
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
12
Cycle 1 Standard Survey Health Date
2014-06-18
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-05-01
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2011-08-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
8.00000
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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