Holston Manor
Holston Manor Information
| Facility Name | Holston Manor |
| Location | 3641 Memorial Blvd, Kingsport, TN 37664 |
| County (SSA Code) | Sullivan (810) |
| Phone Number | 423-246-2411 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 204 |
| Average Number of Residents | 122.2 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | HOLSTON NH OPERATIONS LLC |
| Ownership Type | For profit - Corporation |
| Date First Approved | 1992-08-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 1.84278 |
| Reported LPN Staffing Hours per Resident per Day | 1.03219 |
| Reported RN Staffing - Hours per Resident per Day | 0.58587 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.61805 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.46083 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.09126 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.12419 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.81961 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.44963 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.39343 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.25151 |
| Total Weighted Health Survey Score for three cycles | 10 |
| Rating cycle 1 Standard Survey Health Date | 2020-01-14 |
| Rating cycle 1 - Health Deficiency Score | 3 |
| Rating cycle 1 - Total Health Inspection Score | 4 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-11-28 |
| Rating cycle 2 - Health Deficiency Score | 4 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-11-08 |
| Rating cycle 3 - Health Deficiency Score | 16 |
| Rating cycle 3 - Total Health Inspection Score | 16 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 1 |
| Number of Substantiated Complaints | 1 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |