Tennessee Nursing Homes >> Harrogate Nursing Homes >> Tri State Health And Rehabilitation Center

Tri State Health And Rehabilitation Center - Harrogate Nursing Home

General Information

UPDATE
Federal Provider Number
445263
Provider Name
TRI STATE HEALTH AND REHABILITATION CENTER
Provider Address
600 SHAWANEE RD
HARROGATE, TN 37752
Provider Phone Number
(423) 869-5376
Provider SSA County
120
Provider County Name
Claiborne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
116
Number of Residents in Certified Beds
89
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRI STATE MANOR LLC
Date First Approved to Provide Medicare and Medicaid services
1991-03-21
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
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.19270
Reported LPN Staffing Hours per Resident per Day
0.77921
Reported RN Staffing Hours per Resident per Day
0.41011
Reported Licensed Staffing Hours per Resident per Day
1.18933
Reported Total Nurse Staffing Hours per Resident per Day
3.38202
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09944
Expected CNA Staffing Hours per Resident per Day
2.58066
Expected LPN Staffing Hours per Resident per Day
0.69196
Expected RN Staffing Hours per Resident per Day
1.12953
Expected Total Nurse Staffing Hours per Resident per Day
4.40215
Adjusted CNA Staffing Hours per Resident per Day
2.08483
Adjusted LPN Staffing Hours per Resident per Day
0.93466
Adjusted RN Staffing Hours per Resident per Day
0.27129
Adjusted Total Nurse Staffing Hours per Resident per Day
3.09680
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-01-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
4
Cycle 2 Standard Health Survey Date
2013-12-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-11-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
8.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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