Signature Healthcare Of Cleveland - Cleveland Nursing Home
General Information
UPDATEFederal Provider Number
445369
Provider Name
SIGNATURE HEALTHCARE OF CLEVELAND
Provider Address
2750 EXECUTIVE PARK PLACE
CLEVELAND, TN 37312
CLEVELAND, TN 37312
Provider Phone Number
(423) 476-4444
Provider SSA County
50
Provider County Name
Bradley
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP CLEVELAND LLC
Date First Approved to Provide Medicare and Medicaid services
1996-03-01
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.50407
Reported LPN Staffing Hours per Resident per Day
0.80814
Reported RN Staffing Hours per Resident per Day
0.92674
Reported Licensed Staffing Hours per Resident per Day
1.73488
Reported Total Nurse Staffing Hours per Resident per Day
4.23895
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17849
Expected CNA Staffing Hours per Resident per Day
2.63202
Expected LPN Staffing Hours per Resident per Day
0.70634
Expected RN Staffing Hours per Resident per Day
1.25762
Expected Total Nurse Staffing Hours per Resident per Day
4.59598
Adjusted CNA Staffing Hours per Resident per Day
2.33442
Adjusted LPN Staffing Hours per Resident per Day
0.94962
Adjusted RN Staffing Hours per Resident per Day
0.55061
Adjusted Total Nurse Staffing Hours per Resident per Day
3.71777
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
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
8
Cycle 2 Standard Health Survey Date
2013-10-23
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-10-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
18.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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