Shannondale Of Maryville Health Care Center - Maryville Nursing Home
General Information
UPDATEFederal Provider Number
445472
Provider Name
SHANNONDALE OF MARYVILLE HEALTH CARE CENTER
Provider Address
803 SHANNONDALE WAY
MARYVILLE, TN 37803
MARYVILLE, TN 37803
Provider Phone Number
(865) 982-4599
Provider SSA County
40
Provider County Name
Blount
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
44
Number of Residents in Certified Beds
40
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
PRESBYTERIAN HOMES OF TENNESSEE INC
Date First Approved to Provide Medicare and Medicaid services
2003-07-07
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.93625
Reported LPN Staffing Hours per Resident per Day
1.97875
Reported RN Staffing Hours per Resident per Day
1.59500
Reported Licensed Staffing Hours per Resident per Day
3.57375
Reported Total Nurse Staffing Hours per Resident per Day
7.51000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.40375
Expected CNA Staffing Hours per Resident per Day
2.59837
Expected LPN Staffing Hours per Resident per Day
0.54226
Expected RN Staffing Hours per Resident per Day
0.86791
Expected Total Nurse Staffing Hours per Resident per Day
4.00853
Adjusted CNA Staffing Hours per Resident per Day
3.71710
Adjusted LPN Staffing Hours per Resident per Day
3.02873
Adjusted RN Staffing Hours per Resident per Day
1.37317
Adjusted Total Nurse Staffing Hours per Resident per Day
7.55190
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
2014-05-14
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-05-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2011-09-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
12.00000
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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