WOODBURY HEALTH AND REHABILITATION CENTER

119 WEST HIGH STREET
WOODBURY, TN, 37190
6155635939
CCN: 445435
2
Overall
2
Health
3
Staffing
3
Quality
ChainTWIN RIVERS HEALTH & REHABILITATION
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
OCOEE FOUNDATION INCOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
PIONEER CONSULTING LLCOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
TWIN RIVERS HEALTH & REHABILITATION LLCOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BRADLEY, DONOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BURTON, WILLIAMOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
DAVIS, CLINTONOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
HOLCOMBE, MICHELLEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
KUPCHYNSKY, KATHLEENOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
PHILLIPS, DOROTHYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SHEEHAN, JOHNOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SHEEHAN, MARGARETOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SMITH, FRANKOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SPURLOCK, JAMESOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
WARD, MICHAELOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Health Deficiencies (14)
2024-11-25 · Health
F
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F851 · Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
F
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.
2022-02-16 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
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
F760 · Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
D
F759 · Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
D
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
J
F678 · Quality of Life and Care Deficiencies
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
D
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
2019-05-15 · Health
F
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.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
3.61
3.68
RN Hrs/Resident/Day
0.36
0.54
LPN Hrs/Resident/Day
1.22
0.81
CNA Hrs/Resident/Day
2.02
2.33
PT Hrs/Resident/Day
0.04
0.12
Data as of 2026-03-01