Signature Healthcare At St Peter Villa - Memphis Nursing Home
General Information
UPDATEFederal Provider Number
445139
Provider Name
SIGNATURE HEALTHCARE AT ST PETER VILLA
Provider Address
141 N MCLEAN
MEMPHIS, TN 38104
MEMPHIS, TN 38104
Provider Phone Number
(901) 276-2021
Provider SSA County
780
Provider County Name
Shelby
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
180
Number of Residents in Certified Beds
150
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP MEMPHIS III, LLC
Date First Approved to Provide Medicare and Medicaid services
1981-02-04
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
1
Overall Rating Footnote
Health Inspection Rating
1
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
2.17733
Reported LPN Staffing Hours per Resident per Day
0.97567
Reported RN Staffing Hours per Resident per Day
0.58700
Reported Licensed Staffing Hours per Resident per Day
1.56267
Reported Total Nurse Staffing Hours per Resident per Day
3.74000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10567
Expected CNA Staffing Hours per Resident per Day
2.50146
Expected LPN Staffing Hours per Resident per Day
0.66783
Expected RN Staffing Hours per Resident per Day
1.11406
Expected Total Nurse Staffing Hours per Resident per Day
4.28334
Adjusted CNA Staffing Hours per Resident per Day
2.13576
Adjusted LPN Staffing Hours per Resident per Day
1.21260
Adjusted RN Staffing Hours per Resident per Day
0.39370
Adjusted Total Nurse Staffing Hours per Resident per Day
3.51958
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
22
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
848
Cycle 1 Standard Survey Health Date
2014-08-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
848
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
8
Cycle 2 Standard Health Survey Date
2013-06-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-03-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
440.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
449248
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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