Ivy Hall Nursing Home
301 Watauga Ave, Elizabethton, TN 37643


Ivy Hall Nursing Home is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 445469. The address is 301 Watauga Ave, Elizabethton, TN 37643. The zip code is 37643. The phone number is 4235426512.


Ivy Hall Nursing Home · 301 Watauga Ave, Elizabethton, TN 37643

Federal Provider Number 445469
Provider Name IVY HALL NURSING HOME
Address 301 WATAUGA AVE
ELIZABETHTON, TN 37643
Phone Number 4235426512
SSA County Code 90
County Name Carter
Ownership Type For profit - Individual
Certified Beds 101
Certified Beds Residents 92
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name IVY HALL INC
Date First Approved to Provide Medicare Medicaid Services 12/01/2002
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 Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 4
Quality Measure Rating 4
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.44891
Reported LPN Staffing Hours per Resident per Day 0.83424
Reported RN Staffing Hours per Resident per Day 0.61793
Reported Licensed Staffing Hours per Resident per Day 1.45217
Reported Total Nurse Staffing Hours per Resident per Day 3.90108
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05761
Expected CNA Staffing Hours per Resident per Day 2.57136
Expected LPN Staffing Hours per Resident per Day 0.72058
Expected RN Staffing Hours per Resident per Day 1.18235
Expected Total Nurse Staffing Hours per Resident per Day 4.4743
Adjusted CNA Staffing Hours per Resident per Day 2.33685
Adjusted LPN Staffing Hours per Resident per Day 0.96092
Adjusted RN Staffing Hours per Resident per Day 0.39051
Adjusted Total Nurse Staffing Hours per Resident per Day 3.51449
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 8
Cycle 1 Standard Survey Health Date 05/16/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 8
Cycle 2 Total Number of Health Deficiencies 1
Cycle 2 Number of Standard Health Deficiencies 1
Cycle 2 Health Deficiency Score 4
Cycle 2 Standard Health Survey Date 05/25/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 4
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 06/17/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 12
Total Weighted Health Survey Score 7.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Ivy Hall Nursing Home

Owner Name Role Association Date
CARE CENTERS MANAGEMENT CONSULTING, INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/18/2006
CARTER, JANELLE (Individual) MANAGING EMPLOYEE since 05/30/1986
CARTER, JANELLE (Individual) OFFICER since 05/30/1986
CARTER, JANELLE (Individual) OPERATIONAL/MANAGERIAL CONTROL since 05/30/1986
DELOACH, JUDY (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 06/08/1971
DELOACH, JUDY (Individual) DIRECTOR since 06/08/1971
DELOACH, JUDY (Individual) MANAGING EMPLOYEE since 06/08/1971
DELOACH, JUDY (Individual) OFFICER since 06/08/1971
DELOACH, JUDY (Individual) OPERATIONAL/MANAGERIAL CONTROL since 06/08/1971
WOODWARD, JESSICA (Individual) MANAGING EMPLOYEE since 03/05/2014
WOODWARD, JESSICA (Individual) OPERATIONAL/MANAGERIAL CONTROL since 03/05/2014

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