Provider Name: SIGNATURE HEALTHCARE OF ELIZABETHON REHAB & WELLNE
Address: 1200 SPRUCE LANE, ELIZABETHTON, TN 37643
Phone: (423) 543-3202
County: Carter (090)
Ownership Type: For profit - Limited Liability company
Certified Beds: 94
Average Residents Per Day: 67.6 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: LP ELIZABETHTON LLC
First Approved Date: February 17, 1989
Affiliated Entity: SIGNATURE HEALTHCARE (474)
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 5 ()
QM Rating: 5 ()
Long Stay QM Rating: 5 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.05644, LPN Staff Hours Per Day: 0.8545, RN Staff Hours Per Day: 0.7272, Licensed Staff Hours Per Day: 1.5817
Total Nurse Staff Hours Per Day, per resident: 3.63817
Weekend Nurse Staff Hours: 3.19701, Weekend RN Staff Hours: 0.5274
PT Staff Hours Per Day, per resident: 0.1581
Nurse Staff Turnover: 26.1, Nurse Turnover Note:
RN Turnover: 22.2, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.0709, Case Mix LPN Hours Per Day: 0.7459, Case Mix RN Hours Per Day: 0.4115
Adjusted Nurse Aide Hours Per Day, per resident: 2.02295, Adjusted LPN Hours Per Day: 0.8453, Adjusted RN Hours Per Day: 0.6658
Total Adjusted Nurse Hours Per Day, per resident: 3.55196
Adjusted Weekend Nurse Hours Per Day, per resident: 3.12126
Health Survey Dates and Scores: Cycle 1: 2022-11-09 (Score: 0), Cycle 2: 2019-10-02 (Score: 4), Cycle 3: 2018-11-07 (Score: 12)
Total Weighted Health Score: 3.333
Reported Incidents: 1, Substantiated Complaints: 2
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: 1200 SPRUCE LANE,ELIZABETHTON,TN,37643 (36.3362, -82.211)
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 2019-11-16
Type: Health, Deficiency: Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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 2021-10-01
Type: Health, Deficiency: Reasonably accommodate the needs and preferences of 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 2018-12-10
Type: Health, Deficiency: Ensure each resident receives an accurate assessment.
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 2018-12-10
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: 0161, Version: New
Description: Use approved construction type or materials.
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 2022-11-10
Type: Fire Safety, Tag: 0341, Version: New
Description: Install a fire alarm system that can be heard throughout the facility.
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 2019-11-16
Type: Fire Safety, Tag: 0161, Version: New
Description: Use approved construction type or materials.
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 2018-11-20
Type: Fire Safety, Tag: 0345, Version: New
Description: Have approved installation, maintenance and testing program for fire alarm systems.
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 2018-12-20