Provider Name: AHC HUMBOLDT
Address: 2031 AVONDALE STREET, POBOX 446, HUMBOLDT, TN 38343
Phone: (731) 784-3655
County: Gibson (260)
Ownership Type: For profit - Corporation
Certified Beds: 89
Average Residents Per Day: 52.1 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: HUMBOLDT HEALTHCARE AND REHAB CENTER, LLC
First Approved Date: July 1, 2002
Affiliated Entity: AMERICAN HEALTH COMMUNITIES (30)
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 3 ()
Health Inspection Rating: 3 ()
QM Rating: 3 ()
Long Stay QM Rating: 2 ()
Short Stay QM Rating: 4 ()
Staffing Rating: 3 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 1.93537, LPN Staff Hours Per Day: 1.0971, RN Staff Hours Per Day: 0.5932, Licensed Staff Hours Per Day: 1.6903
Total Nurse Staff Hours Per Day, per resident: 3.62573
Weekend Nurse Staff Hours: 3.04986, Weekend RN Staff Hours: 0.3267
PT Staff Hours Per Day, per resident: 0.0465
Nurse Staff Turnover: 43.8, Nurse Turnover Note:
RN Turnover: 16.7, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.2029, Case Mix LPN Hours Per Day: 0.7957, Case Mix RN Hours Per Day: 0.4388
Adjusted Nurse Aide Hours Per Day, per resident: 1.78980, Adjusted LPN Hours Per Day: 1.0175, Adjusted RN Hours Per Day: 0.5093
Total Adjusted Nurse Hours Per Day, per resident: 3.32460
Adjusted Weekend Nurse Hours Per Day, per resident: 2.79656
Health Survey Dates and Scores: Cycle 1: 2023-09-22 (Score: 24), Cycle 2: 2019-06-26 (Score: 20), Cycle 3: 2018-05-02 (Score: 0)
Total Weighted Health Score: 18.667
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: 2031 AVONDALE STREET, POBOX 446,HUMBOLDT,TN,38343 (35.8376, -88.912)
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: 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 2023-11-01
Type: Health, Deficiency: Honor the resident's right to organize and participate in resident/family groups in 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 2023-11-01
Type: Health, Deficiency: Provide care and assistance to perform activities of daily living for any resident who is unable.
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 2023-11-01
Type: Health, Deficiency: Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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 2023-11-01
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 2023-11-01
Type: Health, Deficiency: Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
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 2023-11-01
Type: Health, Deficiency: Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Severity: G - Level 3: Actual harm that is not immediate jeopardy. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-07-31
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: 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 2023-09-19
Type: Fire Safety, Tag: 0781, Version: New
Description: Have restrictions on the use of portable space heaters.
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 2023-10-10
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 2023-10-09