CUMBERLAND VILLAGE CARE
136 DAVIS LANE
LAFOLLETTE, TN, 37766
4235620760
CCN: 445276
4
Overall4
Health2
Staffing2
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| REGENCY HEALTH SERVICES, LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| FC-GEN OPERATIONS INVESTMENT LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| GEN OPERATIONS I LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| GEN OPERATIONS II LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| GENESIS HEALTHCARE INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| GENESIS HEALTHCARE LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| GENESIS HOLDINGS LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| HCCF MANAGEMENT GROUP XI LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SUN HEALTHCARE GROUP, INC. | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SUNBRIDGE HEALTHCARE LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| ZAC PROPERTIES XI LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| FISHMAN, STEVEN | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| WHITMAN, ARNOLD | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SUNDANCE REHABILITATION HOLDCO INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| WELLTOWER OP LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| MENDELSON, AVI | CORPORATE OFFICER | NOT APPLICABLE |
| BERG, MICHAEL | CORPORATE OFFICER | NOT APPLICABLE |
| BRIDGEFORD, LAURA | CORPORATE OFFICER | NOT APPLICABLE |
| MANSOUR, ELIE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| FLOWERS, ROB | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Penalties (1)
| Date | Type | Amount |
|---|---|---|
| 2024-09-11 | Fine | $19K |
Health Deficiencies (17)
2025-01-30 · Health
E
F908 · Environmental Deficiencies
Keep all essential equipment working safely.
2025-01-14 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F814 · Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F698 · Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
2024-10-23 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2024-09-11 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2023-04-12 · Health
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2021-10-20 · Health
D
F842 · Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
2019-10-29 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F849 · Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
F
F814 · Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
F
F761 · Pharmacy Service Deficiencies
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.
D
F744 · Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
D
F677 · Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
F554 · Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
3.12
RN Hrs/Resident/Day0.54
0.37
LPN Hrs/Resident/Day0.81
0.96
CNA Hrs/Resident/Day2.33
1.79
PT Hrs/Resident/Day0.12
0.05
Data as of 2026-03-01