Pine Meadows Health Care And Rehabilitation Center - Bolivar Nursing Home
General Information
UPDATEFederal Provider Number
445232
Provider Name
PINE MEADOWS HEALTH CARE AND REHABILITATION CENTER
Provider Address
700 NUCKOLLS ROAD
BOLIVAR, TN 38008
BOLIVAR, TN 38008
Provider Phone Number
(731) 658-4707
Provider SSA County
340
Provider County Name
Hardeman
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
134
Number of Residents in Certified Beds
121
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BOLIVAR OPERATOR LLC
Date First Approved to Provide Medicare and Medicaid services
1989-09-06
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
5
Health Inspection Rating Footnote
QM Rating
2
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
2.07190
Reported LPN Staffing Hours per Resident per Day
0.94339
Reported RN Staffing Hours per Resident per Day
0.66488
Reported Licensed Staffing Hours per Resident per Day
1.60826
Reported Total Nurse Staffing Hours per Resident per Day
3.68017
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05661
Expected CNA Staffing Hours per Resident per Day
2.33631
Expected LPN Staffing Hours per Resident per Day
0.61561
Expected RN Staffing Hours per Resident per Day
1.09358
Expected Total Nurse Staffing Hours per Resident per Day
4.04549
Adjusted CNA Staffing Hours per Resident per Day
2.17600
Adjusted LPN Staffing Hours per Resident per Day
1.27194
Adjusted RN Staffing Hours per Resident per Day
0.45429
Adjusted Total Nurse Staffing Hours per Resident per Day
3.66689
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
2015-02-11
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
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
28
Cycle 3 Standard Health Survey Date
2011-10-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
8.66700
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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Nursiong Homes Nearby
Pleasant View Health Care Center
214 North Water Street |
BOLIVAR TN 38008 | 1.1 miles away