Signature Health of Portland Rehab & Wellness Cent
215 Highland Circle Drive, Portland, TN 37148


Signature Health of Portland Rehab & Wellness Cent is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 445306. The address is 215 Highland Circle Drive, Portland, TN 37148. The zip code is 37148. The phone number is 6153259263.


Signature Health of Portland Rehab & Wellness Cent · 215 Highland Circle Drive, Portland, TN 37148

Federal Provider Number 445306
Provider Name SIGNATURE HEALTH OF PORTLAND REHAB & WELLNESS CENT
Address 215 HIGHLAND CIRCLE DRIVE
PORTLAND, TN 37148
Phone Number 6153259263
SSA County Code 820
County Name Sumner
Ownership Type For profit - Corporation
Certified Beds 112
Certified Beds Residents 97
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name LP PORTLAND, LLC
Date First Approved to Provide Medicare Medicaid Services 01/01/1993
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 3
Health Inspection Rating 2
Quality Measure Rating 5
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 1.9634
Reported LPN Staffing Hours per Resident per Day 0.96237
Reported RN Staffing Hours per Resident per Day 0.6567
Reported Licensed Staffing Hours per Resident per Day 1.61907
Reported Total Nurse Staffing Hours per Resident per Day 3.58247
Reported Physical Therapist Staffing Hours per Resident Per Day 0.12835
Expected CNA Staffing Hours per Resident per Day 2.61411
Expected LPN Staffing Hours per Resident per Day 0.6482
Expected RN Staffing Hours per Resident per Day 1.03991
Expected Total Nurse Staffing Hours per Resident per Day 4.30222
Adjusted CNA Staffing Hours per Resident per Day 1.84292
Adjusted LPN Staffing Hours per Resident per Day 1.23228
Adjusted RN Staffing Hours per Resident per Day 0.47185
Adjusted Total Nurse Staffing Hours per Resident per Day 3.35654
Cycle 1 Total Number of Health Deficiencies 8
Cycle 1 Number of Standard Health Deficiencies 8
Cycle 1 Number of Complaint Health Deficiencies 2
Cycle 1 Health Deficiency Score 52
Cycle 1 Standard Survey Health Date 11/02/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 52
Cycle 2 Total Number of Health Deficiencies 5
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Number of Complaint Health Deficiencies 1
Cycle 2 Health Deficiency Score 32
Cycle 2 Standard Health Survey Date 09/03/2015
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 12
Cycle 3 Standard Health Survey Date 07/22/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 12
Total Weighted Health Survey Score 38.667
Number of Facility Reported Incidents 6
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Signature Health of Portland Rehab & Wellness Cent

Owner Name Role Association Date
ADAMS, SANDRA (Individual) OFFICER since 12/15/2014
ASCHENBECK, JAMES (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/15/2014
HARRISON, JOHN (Individual) OFFICER since 12/15/2014
JJLA LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/15/2014
LAS PALMAS SNF LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/15/2014
LPSNF LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/15/2014
MCCHURCH, CONNOR (Individual) OPERATIONAL/MANAGERIAL CONTROL since 06/30/2017
SHC LP HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 12/15/2014
SIGNATURE HEALTHCARE CLINICAL CONSULTING SERVICES LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/15/2014
SIGNATURE HEALTHCARE CONSULTING SERVICES LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/15/2014
SIGNATURE HEALTHCARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/15/2014
SMEDRA, IRA (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/15/2014
STEIER, E (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/15/2014
WHEATEN LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/15/2014
WINTNER, JACOB (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/15/2014

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