Provider Name: DIVERSICARE OF MARTIN
Address: 158 MT PELIA RD, MARTIN, TN 38237
Phone: (731) 587-0503
County: Weakley (910)
Ownership Type: For profit - Corporation
Certified Beds: 150
Average Residents Per Day: 91.6 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: DIVERSICARE LEASING LP
First Approved Date: April 11, 1990
Affiliated Entity: DIVERSICARE HEALTHCARE (185)
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 4 ()
Health Inspection Rating: 4 ()
QM Rating: 3 ()
Long Stay QM Rating: 4 ()
Short Stay QM Rating: 2 ()
Staffing Rating: 3 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 1.75991, LPN Staff Hours Per Day: 0.8960, RN Staff Hours Per Day: 0.4808, Licensed Staff Hours Per Day: 1.3768
Total Nurse Staff Hours Per Day, per resident: 3.13678
Weekend Nurse Staff Hours: 2.48868, Weekend RN Staff Hours: 0.1502
PT Staff Hours Per Day, per resident: 0.0616
Nurse Staff Turnover: 35.8, Nurse Turnover Note:
RN Turnover: 0.0, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 1.9002, Case Mix LPN Hours Per Day: 0.7329, Case Mix RN Hours Per Day: 0.3418
Adjusted Nurse Aide Hours Per Day, per resident: 1.88676, Adjusted LPN Hours Per Day: 0.9021, Adjusted RN Hours Per Day: 0.5300
Total Adjusted Nurse Hours Per Day, per resident: 3.32337
Adjusted Weekend Nurse Hours Per Day, per resident: 2.63671
Health Survey Dates and Scores: Cycle 1: 2021-06-16 (Score: 24), Cycle 2: 2020-03-04 (Score: 0), Cycle 3: 2019-04-03 (Score: 20)
Total Weighted Health Score: 15.333
Reported Incidents: 0, Substantiated Complaints: 1
Infection Control Citations: 0
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 657.80, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: 158 MT PELIA RD,MARTIN,TN,38237 (36.3337, -88.869)
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: Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
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 2021-07-16
Type: Health, Deficiency: Ensure that residents are free from significant medication errors.
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 2021-07-16
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 2021-07-16
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 2022-02-25
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 2019-04-25
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: 0004, Version: New
Description: Develop and maintain an Emergency Preparedness Program (EP).
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 2021-07-16
Type: Fire Safety, Tag: 0521, Version: New
Description: Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
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 2021-07-16
Type: Fire Safety, Tag: 0761, Version: New
Description: To conduct inspection, testing and maintenance of fire doors by qualified individuals.
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 2021-07-31
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 2020-04-18
Type: Fire Safety, Tag: 0920, Version: New
Description: Ensure proper usage of power strips and extension cords.
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 2020-03-02
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 2019-04-10
Type: Fire Safety, Tag: 0741, Version: New
Description: Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
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