Nursing Home

CUMBERLAND VILLAGE CARE

Overall Rating

Cited for abuse

Address

136 Davis Lane

Lafollette, TN 37766

Contact

4235620760

Certification Date

1992-01-15

Details

CMS Certification Number

445276

Ownership Type

For profit - Limited Liability company

Number of Certified Beds

182

Average Number of Residents per Day

161.0

Provider Type

Medicare and Medicaid

Legal Business Name

SUNBRIDGE REGENCY - TENNESSEE, LLC

Affiliated Entity Name

GENESIS HEALTHCARE

Affiliated Entity ID

237

Ratings

Health Inspection Rating

2

Quality Measure Rating

3

Staffing Rating

2

Staffing

Reported Nurse Aide Staffing Hours per Resident per Day

1.76605

Reported LPN Staffing Hours per Resident per Day

0.88774

Reported RN Staffing Hours per Resident per Day

0.40616

Reported Total Nurse Staffing Hours per Resident per Day

3.05994

Total Number of Nurse Staff Hours per Resident per Day on the Weekend

2.61458

Registered Nurse Hours per Resident per Day on the Weekend

0.17428

Reported Physical Therapist Staffing Hours per Resident Per Day

0.04035

Quality Measures

Long-Stay Quality Measure Rating

3

Short-Stay Quality Measure Rating

3

Inspections

Total Weighted Health Survey Score

34.667

Number of Facility Reported Incidents

7

Number of Substantiated Complaints

2

Number of Citations from Infection Control Inspections

0

Health Inspections

Rating Cycle 1

Standard Health Survey Date

2021-10-20

Total Number of Health Deficiencies

2

Number of Standard Health Deficiencies

1

Number of Complaint Health Deficiencies

1

Health Deficiency Score

8

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

8

Rating Cycle 2

Standard Health Survey Date

2019-10-29

Total Number of Health Deficiencies

9

Number of Standard Health Deficiencies

7

Number of Complaint Health Deficiencies

2

Health Deficiency Score

76

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

76

Rating Cycle 3

Standard Health Survey Date

2018-12-12

Total Number of Health Deficiencies

5

Number of Standard Health Deficiencies

3

Number of Complaint Health Deficiencies

2

Health Deficiency Score

32

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

32

Penalties

Number of Fines

1

Total Amount of Fines in Dollars

11628.50

Number of Payment Denials

1

Total Number of Penalties

2