Willow Ridge Center - Maynardville Nursing Home
General Information
UPDATEFederal Provider Number
445284
Provider Name
WILLOW RIDGE CENTER
Provider Address
215 RICHARDSON WAY
MAYNARDVILLE, TN 37807
MAYNARDVILLE, TN 37807
Provider Phone Number
8659925816
Provider SSA County
860
Provider County Name
Union
Ownership Type
For profit - Corporation
Number of Certified Beds
77
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SUNBRIDGE REGENCY - TENNESSEE, INC.
Date First Approved to Provide Medicare and Medicaid services
1992-03-27
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
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
1.70405
Reported LPN Staffing Hours per Resident per Day
0.45473
Reported RN Staffing Hours per Resident per Day
0.72703
Reported Licensed Staffing Hours per Resident per Day
1.18176
Reported Total Nurse Staffing Hours per Resident per Day
2.88581
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06824
Expected CNA Staffing Hours per Resident per Day
2.53595
Expected LPN Staffing Hours per Resident per Day
0.66845
Expected RN Staffing Hours per Resident per Day
1.03568
Expected Total Nurse Staffing Hours per Resident per Day
4.24008
Adjusted CNA Staffing Hours per Resident per Day
1.64878
Adjusted LPN Staffing Hours per Resident per Day
0.56463
Adjusted RN Staffing Hours per Resident per Day
0.52452
Adjusted Total Nurse Staffing Hours per Resident per Day
2.74344
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-12-17
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-11-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-06-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
15.33300
Number of Facility Reported Incidents
1
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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