Serene Manor Medical Ctr. - Knoxville Nursing Home
General Information
UPDATEFederal Provider Number
440000000000000000000000000000
Provider Name
SERENE MANOR MEDICAL CTR.
Provider Address
970 WRAY ST
KNOXVILLE, TN 37917
KNOXVILLE, TN 37917
Provider Phone Number
(865) 523-9171
Provider SSA County
460
Provider County Name
Knox
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
79
Number of Residents in Certified Beds
77
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
1.91104
Reported LPN Staffing Hours per Resident per Day
1.09156
Reported RN Staffing Hours per Resident per Day
0.42468
Reported Licensed Staffing Hours per Resident per Day
1.51623
Reported Total Nurse Staffing Hours per Resident per Day
3.42728
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02792
Expected CNA Staffing Hours per Resident per Day
2.01466
Expected LPN Staffing Hours per Resident per Day
0.52694
Expected RN Staffing Hours per Resident per Day
0.73126
Expected Total Nurse Staffing Hours per Resident per Day
3.27285
Adjusted CNA Staffing Hours per Resident per Day
2.32750
Adjusted LPN Staffing Hours per Resident per Day
1.71935
Adjusted RN Staffing Hours per Resident per Day
0.43394
Adjusted Total Nurse Staffing Hours per Resident per Day
4.22109
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-03-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2011-08-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
42.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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