Life Care Center of Centerville
112 Old Dickson Rd, Centerville, TN 37033


Life Care Center of Centerville is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 445252. The address is 112 Old Dickson Rd, Centerville, TN 37033. The zip code is 37033. The phone number is 9317294236.


Life Care Center of Centerville · 112 Old Dickson Rd, Centerville, TN 37033

Federal Provider Number 445252
Provider Name LIFE CARE CENTER OF CENTERVILLE
Address 112 OLD DICKSON RD
CENTERVILLE, TN 37033
Phone Number 9317294236
SSA County Code 400
County Name Hickman
Ownership Type For profit - Corporation
Certified Beds 132
Certified Beds Residents 68
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name CENTERVILLE MEDICAL INVESTORS, LLC
Date First Approved to Provide Medicare Medicaid Services 05/14/1990
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 2
Reported CNA Staffing Hours per Resident per Day 2.28824
Reported LPN Staffing Hours per Resident per Day 1.32206
Reported RN Staffing Hours per Resident per Day 0.40735
Reported Licensed Staffing Hours per Resident per Day 1.72941
Reported Total Nurse Staffing Hours per Resident per Day 4.01765
Reported Physical Therapist Staffing Hours per Resident Per Day 0.19853
Expected CNA Staffing Hours per Resident per Day 2.45269
Expected LPN Staffing Hours per Resident per Day 0.60332
Expected RN Staffing Hours per Resident per Day 0.95584
Expected Total Nurse Staffing Hours per Resident per Day 4.01185
Adjusted CNA Staffing Hours per Resident per Day 2.28918
Adjusted LPN Staffing Hours per Resident per Day 1.81879
Adjusted RN Staffing Hours per Resident per Day 0.31843
Adjusted Total Nurse Staffing Hours per Resident per Day 4.03673
Cycle 1 Total Number of Health Deficiencies 4
Cycle 1 Number of Standard Health Deficiencies 4
Cycle 1 Health Deficiency Score 48
Cycle 1 Standard Survey Health Date 05/24/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 48
Cycle 2 Total Number of Health Deficiencies 5
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Health Deficiency Score 32
Cycle 2 Standard Health Survey Date 03/10/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 32
Cycle 3 Total Number of Health Deficiencies 3
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 03/04/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 38
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Life Care Center of Centerville

Owner Name Role Association Date
CROSS, CINDY (Individual) OFFICER since 09/30/2001
LIFE CARE CENTERS OF AMERICA, INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 10/13/2001
PRESTON, FORREST (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/15/2005
THURMOND, JOAN (Individual) OFFICER since 09/30/2004
WALL, BEVERLY (Individual) MANAGING EMPLOYEE since 11/12/2012

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