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Serene Manor Medical Ctr.

Non profit - Corporation  ·  970 Wray St, Knoxville, TN 37917  ·  See home’s Medicare page

Special Focus Facility Candidate
Has a history of serious quality issues but has not been formally flagged by the government.
No Ownership Data Provided
Home did not provide details about ownership and managerial control of the facility.
3.15
Nurse hours/resident/day
Reported total nurse staffing hours per resident per day.
State Average: 3.7
41.1%
Nurse turnover
The percentage of nursing staff who stopped working at the home over a 12-month period.
State Average: 53.4%
79
Certified beds
Qualifying beds in the certified provider or supplier facility.
66
Average residents/day
Average number of residents based on daily census.

Inspection Reports

34

total deficiencies

1

infection-related deficiency

This home violated federal standards protecting residents from the spread of infections.

Inspection reports document deficiencies, which are nursing homes’ failures to meet care requirements. The Centers for Medicare and Medicaid Services releases the last three standard inspection reports, as well as the last 36 months of complaint and infection-control reports.
Jun 5, 2023
Complaint report
1 deficiency
D

Administration Deficiency — F0773
Failure to: Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Mar 23, 2023
Complaint report
1 deficiency
D

Freedom from Abuse, Neglect, and Exploitation Deficiency — F0600
Failure to: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

May 24, 2022
Standard report
10 deficiencies
D

to K
K

Quality of Life and Care Deficiency — F0689
Failure to: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Severity
Immediate jeopardy to resident health or safety
Scope
Some people affected
Seriousness
K

Administration Deficiency — F0867
Failure to: Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Severity
Immediate jeopardy to resident health or safety
Scope
Some people affected
Seriousness
K

Resident Assessment and Care Planning Deficiency — F0656
Failure to: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Severity
Immediate jeopardy to resident health or safety
Scope
Few people affected
Seriousness
J

Nutrition and Dietary Deficiency — F0812
Failure to: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Many people affected
Seriousness
F

Pharmacy Service Deficiency — F0761
Failure to: Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E

Freedom from Abuse, Neglect, and Exploitation Deficiency — F0604
Failure to: Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Resident Assessment and Care Planning Deficiency — F0641
Failure to: Ensure each resident receives an accurate assessment.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Resident Assessment and Care Planning Deficiency — F0657
Failure to: Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Pharmacy Service Deficiency — F0755
Failure to: Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Freedom from Abuse, Neglect, and Exploitation Deficiency — F0600
Failure to: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Oct 6, 2021
Complaint report
1 deficiency
G

Quality of Life and Care Deficiency — F0689
Failure to: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Severity
Actual harm that is not immediate jeopardy
Scope
Few people affected
Seriousness
G

Jun 10, 2021
Complaint report
13 deficiencies
D

to L
L

Freedom from Abuse, Neglect, and Exploitation Deficiency — F0600
Failure to: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Resident Assessment and Care Planning Deficiency — F0656
Failure to: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Quality of Life and Care Deficiency — F0677
Failure to: Provide care and assistance to perform activities of daily living for any resident who is unable.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Quality of Life and Care Deficiency — F0686
Failure to: Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Nursing and Physician Services Deficiency — F0710
Failure to: Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Nursing and Physician Services Deficiency — F0725
Failure to: Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Administration Deficiency — F0835
Failure to: Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Administration Deficiency — F0837
Failure to: Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Nursing and Physician Services Deficiency — F0841
Failure to: Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Resident Assessment and Care Planning Deficiency — F0842
Failure to: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Administration Deficiency — F0865
Failure to: Have a plan that describes the process for conducting QAPI and QAA activities.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Freedom from Abuse, Neglect, and Exploitation Deficiency — F0943
Failure to: Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Severity
Immediate jeopardy to resident health or safety
Scope
Many people affected
Seriousness
L

Freedom from Abuse, Neglect, and Exploitation Deficiency — F0604
Failure to: Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Aug 27, 2019
Standard report
4 deficiencies
(1 infection)

This report includes a citation for violating federal standards protecting residents from the spread of infections.

D

to F
F

Nutrition and Dietary Deficiency — F0812
Failure to: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Many people affected
Seriousness
F

Quality of Life and Care Deficiency — F0689
Failure to: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E

Resident Rights Deficiency — F0558
Failure to: Reasonably accommodate the needs and preferences of each resident.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Infection Control Deficiency — F0880
Failure to: Provide and implement an infection prevention and control program.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Aug 15, 2018
Standard report
4 deficiencies
D

to F
F

Nutrition and Dietary Deficiency — F0812
Failure to: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Many people affected
Seriousness
F

Freedom from Abuse, Neglect, and Exploitation Deficiency — F0604
Failure to: Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Resident Assessment and Care Planning Deficiency — F0636
Failure to: Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Resident Assessment and Care Planning Deficiency — F0638
Failure to: Assure that each resident's assessment is updated at least once every 3 months.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D

Penalties

This home has no record of fines or payment suspensions for the past three years.