Provider Name: THE WATERS OF JOHNSON CITY, LLC
Address: 140 TECHNOLOGY LANE, JOHNSON CITY, TN 37604
Phone: (423) 434-2016
County: Washington (890)
Ownership Type: For profit - Limited Liability company
Certified Beds: 84
Average Residents Per Day: 57.0 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: THE WATERS OF JOHNSON CITY, LLC
First Approved Date: November 20, 2007
Affiliated Entity: INFINITY HEALTHCARE MANAGEMENT (283)
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: 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: 1.82182, LPN Staff Hours Per Day: 1.0451, RN Staff Hours Per Day: 0.3506, Licensed Staff Hours Per Day: 1.3958
Total Nurse Staff Hours Per Day, per resident: 3.21765
Weekend Nurse Staff Hours: 2.61685, Weekend RN Staff Hours: 0.2723
PT Staff Hours Per Day, per resident: 0.0925
Nurse Staff Turnover: 83.6, Nurse Turnover Note:
RN Turnover: 60.0, RN Turnover Note:
Admin Left Number: 2, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.4294, Case Mix LPN Hours Per Day: 0.8455, Case Mix RN Hours Per Day: 0.4270
Adjusted Nurse Aide Hours Per Day, per resident: 1.52769, Adjusted LPN Hours Per Day: 0.9121, Adjusted RN Hours Per Day: 0.3094
Total Adjusted Nurse Hours Per Day, per resident: 2.73957
Adjusted Weekend Nurse Hours Per Day, per resident: 2.22804
Health Survey Dates and Scores: Cycle 1: 2022-01-20 (Score: 24), Cycle 2: 2019-06-19 (Score: 0), Cycle 3: 2018-07-03 (Score: 4)
Total Weighted Health Score: 12.667
Reported Incidents: 0, Substantiated Complaints: 1
Infection Control Citations: 3
Fines and Penalties: Number of Fines: 2, Total Fines in Dollars: 1649.18, Payment Denials Number: 0, Total Penalties Number: 2
Location and GPS: 140 TECHNOLOGY LANE,JOHNSON CITY,TN,37604 (36.3356, -82.398)
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 2024-02-27
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 2024-02-27
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 2024-02-27
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 2023-03-24
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 2022-03-04
Type: Health, Deficiency: Provide safe and appropriate respiratory care for a resident when needed.
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 2022-03-04
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 2018-07-20
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: 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 2022-03-07
Type: Fire Safety, Tag: 0006, Version: New
Description: Conduct risk assessment and an All-Hazards approach.
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 2022-03-07
Type: Fire Safety, Tag: 0200, Version: New
Description: Meet other general requirements.
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 2022-03-07
Type: Fire Safety, Tag: 0921, Version: New
Description: Ensure that testing and maintenance of electrical equipment is performed.
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 2022-03-07
Type: Fire Safety, Tag: 0918, Version: New
Description: Have generator or other power source capable of supplying service within 10 seconds.
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 2019-08-02
Type: Fire Safety, Tag: 0921, Version: New
Description: Ensure that testing and maintenance of electrical equipment is performed.
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 2019-08-02