Provider Name: W D BILL MANNING TENNESSEE STATE VETERANS HOME
Address: 2865 MAIN STREET, HUMBOLDT, TN 38343
Phone: (731) 784-8405
County: Gibson (260)
Ownership Type: Government - State
Certified Beds: 140
Average Residents Per Day: 113. ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: TENNESSEE STATE VETERANS HOME BOARD
First Approved Date: February 15, 1996
Affiliated Entity: ()
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: 3 ()
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.77587, LPN Staff Hours Per Day: 1.4942, RN Staff Hours Per Day: 0.4529, Licensed Staff Hours Per Day: 1.9472
Total Nurse Staff Hours Per Day, per resident: 4.72309
Weekend Nurse Staff Hours: 3.73707, Weekend RN Staff Hours: 0.1706
PT Staff Hours Per Day, per resident: 0.0336
Nurse Staff Turnover: 30.9, Nurse Turnover Note:
RN Turnover: 43.8, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.0147, Case Mix LPN Hours Per Day: 0.7509, Case Mix RN Hours Per Day: 0.3450
Adjusted Nurse Aide Hours Per Day, per resident: 2.80682, Adjusted LPN Hours Per Day: 1.4685, Adjusted RN Hours Per Day: 0.4947
Total Adjusted Nurse Hours Per Day, per resident: 4.78583
Adjusted Weekend Nurse Hours Per Day, per resident: 3.78672
Health Survey Dates and Scores: Cycle 1: 2023-10-19 (Score: 8), Cycle 2: 2021-11-17 (Score: 36), Cycle 3: 2020-02-06 (Score: 0)
Total Weighted Health Score: 16.000
Reported Incidents: 0, 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: 2865 MAIN STREET,HUMBOLDT,TN,38343 (35.8174, -88.899)
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: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
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 2023-11-30
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 2023-11-30
Type: Health, Deficiency: Allow residents to self-administer drugs if determined clinically appropriate.
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 2021-12-24
Type: Health, Deficiency: Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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 2021-12-24
Type: Health, Deficiency: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-12-24
Type: Health, Deficiency: Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
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 2021-12-24
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
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 2021-12-24
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: 0372, Version: New
Description: Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
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 2023-11-30
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 2023-10-23
Type: Fire Safety, Tag: 0026, Version: New
Description: Establish roles under a Waiver declared by secretary.
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 2020-02-17