Provider Name: AGAPE REHABILITATION & NURSING CENTER, A WATERS CM
Address: 505 N ROAN STREET, JOHNSON CITY, TN 37604
Phone: (423) 975-2000
County: Washington (890)
Ownership Type: For profit - Limited Liability company
Certified Beds: 84
Average Residents Per Day: 63.9 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: AGAPE REHABILITATION & NURSING CENTER A WATERS COMMUNITY LLC
First Approved Date: November 28, 1983
Affiliated Entity: INFINITY HEALTHCARE MANAGEMENT (283)
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Both
Sprinkler System Status: Yes
Overall Rating: 4 ()
Health Inspection Rating: 4 ()
QM Rating: 5 ()
Long Stay QM Rating: 4 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 1 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 1.78391, LPN Staff Hours Per Day: 0.8292, RN Staff Hours Per Day: 0.6195, Licensed Staff Hours Per Day: 1.4487
Total Nurse Staff Hours Per Day, per resident: 3.23266
Weekend Nurse Staff Hours: 2.70446, Weekend RN Staff Hours: 0.5209
PT Staff Hours Per Day, per resident: 0.0558
Nurse Staff Turnover: 53.2, Nurse Turnover Note:
RN Turnover: 63.6, RN Turnover Note:
Admin Left Number: 1, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.4742, Case Mix LPN Hours Per Day: 0.8741, Case Mix RN Hours Per Day: 0.4575
Adjusted Nurse Aide Hours Per Day, per resident: 1.46884, Adjusted LPN Hours Per Day: 0.7000, Adjusted RN Hours Per Day: 0.5101
Total Adjusted Nurse Hours Per Day, per resident: 2.67727
Adjusted Weekend Nurse Hours Per Day, per resident: 2.23982
Health Survey Dates and Scores: Cycle 1: 2021-07-20 (Score: 4), Cycle 2: 2019-03-26 (Score: 20), Cycle 3: 2018-05-02 (Score: 20)
Total Weighted Health Score: 12.000
Reported Incidents: 3, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 505 N ROAN STREET,JOHNSON CITY,TN,37604 (36.3410, -82.375)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-04-05
Type: Health, Deficiency: Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-04-04
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-04-04
Type: Health, Deficiency: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-02-18
Type: Health, Deficiency: Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-08
Type: Health, Deficiency: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-08
Type: Health, Deficiency: Provide or obtain dental services for each resident.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-08
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-08
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0353, Version: New
Description: Inspect, test, and maintain automatic sprinkler systems.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-04-04
Type: Fire Safety, Tag: 0211, Version: New
Description: Keep aisles, corridors, and exits free of obstruction in case of emergency.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-06-08