Church Hill Care & Rehab Ctr
701 West Main Blvd, Church Hill, TN 37642


Church Hill Care & Rehab Ctr is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 445237. The address is 701 West Main Blvd, Church Hill, TN 37642. The zip code is 37642. The phone number is 4233577178.


Church Hill Care & Rehab Ctr · 701 West Main Blvd, Church Hill, TN 37642

Federal Provider Number 445237
Provider Name CHURCH HILL CARE & REHAB CTR
Address 701 WEST MAIN BLVD
CHURCH HILL, TN 37642
Phone Number 4233577178
SSA County Code 360
County Name Hawkins
Ownership Type For profit - Corporation
Certified Beds 124
Certified Beds Residents 107
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name VANGUARD OF CHURCH HILL, LLC
Date First Approved to Provide Medicare Medicaid Services 09/23/1989
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 2
Quality Measure Rating 3
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 1.79953
Reported LPN Staffing Hours per Resident per Day 1.14019
Reported RN Staffing Hours per Resident per Day 0.60607
Reported Licensed Staffing Hours per Resident per Day 1.74626
Reported Total Nurse Staffing Hours per Resident per Day 3.54579
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05327
Expected CNA Staffing Hours per Resident per Day 2.50537
Expected LPN Staffing Hours per Resident per Day 0.64322
Expected RN Staffing Hours per Resident per Day 1.04354
Expected Total Nurse Staffing Hours per Resident per Day 4.19213
Adjusted CNA Staffing Hours per Resident per Day 1.76241
Adjusted LPN Staffing Hours per Resident per Day 1.47129
Adjusted RN Staffing Hours per Resident per Day 0.43396
Adjusted Total Nurse Staffing Hours per Resident per Day 3.40942
Cycle 1 Total Number of Health Deficiencies 3
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Number of Complaint Health Deficiencies 2
Cycle 1 Health Deficiency Score 12
Cycle 1 Standard Survey Health Date 03/01/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 12
Cycle 2 Total Number of Health Deficiencies 12
Cycle 2 Number of Standard Health Deficiencies 8
Cycle 2 Number of Complaint Health Deficiencies 4
Cycle 2 Health Deficiency Score 76
Cycle 2 Standard Health Survey Date 02/23/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 76
Cycle 3 Total Number of Health Deficiencies 8
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Number of Complaint Health Deficiencies 6
Cycle 3 Health Deficiency Score 40
Cycle 3 Standard Health Survey Date 02/03/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 40
Total Weighted Health Survey Score 38
Number of Facility Reported Incidents 2
Number of Substantiated Complaints 8
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Church Hill Care & Rehab Ctr

Owner Name Role Association Date
CHURCH HILL MANAGEMENT ASSOCIATES, INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 02/04/1998
ERVIN GENERAL PARTNERSHIP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/24/1998
ERVIN, WILLIAM (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/19/2007
FICK, JOHN (Individual) OFFICER since 09/20/2014
GENERAL ELECTRIC CAPITAL CORPORATION (Organization) 5% OR GREATER MORTGAGE INTEREST since 07/29/2011
HARRIS, GINA (Individual) MANAGING EMPLOYEE since 01/23/2013
HEBERT, KIRK (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/01/1999
JERE SUZANNE ERVIN IRRV TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/04/1998
ORAND LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/04/1998
ORAND, WILLIAM (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/04/1998
ORAND, WILLIAM (Individual) DIRECTOR since 02/04/1998
ORAND, WILLIAM (Individual) OFFICER since 02/04/1998
PARVIN, SUSAN (Individual) MANAGING EMPLOYEE since 06/01/2014
SMOTHERS, JERE (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/04/1998
VANGUARD HEALTHCARE, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 02/04/1998
WILLIAM JEFFREY ERVIN IRRV TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/04/1998

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