Pavilion-ths, Llc - Lebanon Nursing Home
General Information
UPDATEFederal Provider Number
445500
Provider Name
PAVILION-THS, LLC
Provider Address
1406 MEDICAL CENTER DRIVE
LEBANON, TN 37087
LEBANON, TN 37087
Provider Phone Number
(615) 444-2882
Provider SSA County
940
Provider County Name
Wilson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PAVILION-THS, LLC
Date First Approved to Provide Medicare and Medicaid services
2010-12-17
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
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.56034
Reported LPN Staffing Hours per Resident per Day
1.03103
Reported RN Staffing Hours per Resident per Day
0.59138
Reported Licensed Staffing Hours per Resident per Day
1.62241
Reported Total Nurse Staffing Hours per Resident per Day
4.18275
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05431
Expected CNA Staffing Hours per Resident per Day
2.56303
Expected LPN Staffing Hours per Resident per Day
0.59018
Expected RN Staffing Hours per Resident per Day
0.90837
Expected Total Nurse Staffing Hours per Resident per Day
4.06158
Adjusted CNA Staffing Hours per Resident per Day
2.45112
Adjusted LPN Staffing Hours per Resident per Day
1.45000
Adjusted RN Staffing Hours per Resident per Day
0.48645
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15115
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-29
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
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
56
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-02-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
22.66700
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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