Cycle 1
Health 2020-02-13 · Fire 2020-02-13
3 health deficiencies
Top issue: Infection Control (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Athens, AL
Limestone Nursing And Rehabilitation Center, LLC
3-star overall rating with 3-star inspections with 3 recent health deficiencies
1600 West Hobbs Street, Athens, AL
(256) 232-3461
Overall
3 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
170
Certified beds
Average residents
135
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Preston Health Services
Operator or chain grouping
Approved since
1979-01-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
5 facilities
Chain averages 3 overall / 3 health / 3 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.45
Registered nurse staffing · state 0.64 · national 0.68
LPN hours / resident day
1.06
Licensed practical nurse staffing · state 0.78 · national 0.87
Aide hours / resident day
2.54
Nurse aide staffing · state 2.50 · national 2.35
Total nurse hours
4.05
All reported nurse hours · state 3.91 · national 3.89
Licensed hours
1.51
RN + LPN hours · state 1.42 · national 1.54
Weekend hours
3.37
Weekend nurse staffing · state 3.29 · national 3.43
Weekend RN hours
0.23
Weekend registered nurse coverage · state 0.36 · national 0.47
Physical therapist
0.03
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
0.47
CMS adjusted RN staffing hours
Adjusted total hours
4.19
CMS adjusted total nurse staffing hours
Case-mix index
1.32
Higher values indicate more complex resident acuity
RN turnover
43%
Annual RN turnover · state 42% · national 45%
Total nurse turnover
50%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
8,817
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
25.58
Composite VBP score used to determine payment impact.
Payment multiplier
0.9839
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Baseline 22.34% · Performance 22.70% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
3.12
Baseline 5.95% · Performance 6.90% · Measure score 3.12 · Achievement 3.12 · Improvement 0
Total nurse turnover
5.71
Performance 40.34% · Measure score 5.71 · Achievement 5.71 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
1.40
Baseline 2.99 hours · Performance 3.48 hours · Measure score 1.40 · Achievement 1.40 · Improvement 1.24
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.67% |
10.72%
1.1 pts better
|
No Different than the National Rate · Eligible stays 257 · Observed rate 6.61% · Lower 95% interval 7.09% |
| Discharge to community | 55.89% |
50.57%
5.3 pts better
|
No Different than the National Rate · Eligible stays 249 · Observed rate 55.82% · Lower 95% interval 49.61% |
| Medicare spending per beneficiary | 1.03 |
1.02
About the same
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 168 · Denominator 168 |
| Falls with major injury | 0.6% |
0.77%
0.2 pts better
|
Numerator 1 · Denominator 168 |
| Discharge self-care score | 51.69% |
53.69%
2 pts worse
|
Numerator 61 · Denominator 118 |
| Discharge mobility score | 59.32% |
50.94%
8.4 pts better
|
Numerator 70 · Denominator 118 |
| Pressure ulcers or injuries, new or worsened | 2.98% |
2.29%
0.7 pts worse
|
Numerator 5 · Denominator 168 · Adjusted rate 2.74% |
| Healthcare-associated infections requiring hospitalization | 6.9% |
7.12%
0.2 pts better
|
No Different than the National Rate · Eligible stays 167 · Observed rate 5.39% · Lower 95% interval 4.16% |
| Staff COVID-19 vaccination coverage | 1.24% |
8.2%
7 pts worse
|
Numerator 2 · Denominator 161 |
| Staff flu vaccination coverage | 27.31% |
42%
14.7 pts worse
|
Numerator 65 · Denominator 238 |
| Discharge function score | 55.93% |
56.45%
0.5 pts worse
|
Numerator 66 · Denominator 118 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 35 · Denominator 35 |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 103 · Denominator 103 |
| Resident COVID-19 vaccinations up to date | 23.16% |
25.2%
2 pts worse
|
Numerator 22 · Denominator 95 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.8 |
2.0
0.2 pts better
|
1.9
0.1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.8 · Observed 1.5 · Expected 1.6 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.1 |
1.8
0.3 pts worse
|
1.8
0.3 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.1 · Observed 1.8 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 98.9% |
91.3%
7.6 pts better
|
93.4%
5.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 98.1% · Q2 99.1% · Q3 99.1% · Q4 99.1% · 4Q avg 98.9% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 96.5% |
94.8%
1.7 pts better
|
95.5%
1 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 96.5% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 1.8% |
3.4%
1.6 pts better
|
3.3%
1.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.9% · Q2 1.9% · Q3 1.9% · Q4 1.7% · 4Q avg 1.8% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.0% |
1.3%
1.3 pts better
|
11.4%
11.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents who lose too much weight | 0.0% |
5.3%
5.3 pts better
|
5.4%
5.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 43.7% |
24.9%
18.8 pts worse
|
19.6%
24.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 46.2% · Q2 43.3% · Q3 44.6% · Q4 40.9% · 4Q avg 43.7% |
| Percentage of long-stay residents who received an antipsychotic medication | 20.7% |
22.8%
2.1 pts better
|
16.7%
4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 23.3% · Q2 20.9% · Q3 22.7% · Q4 15.9% · 4Q avg 20.7% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.6%
0.6 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 7.2% |
14.8%
7.6 pts better
|
16.3%
9.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.0% · Q2 5.2% · Q3 4.7% · Q4 8.1% · 4Q avg 7.2% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 7.4% |
13.4%
6 pts better
|
14.9%
7.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.3% · Q2 10.8% · Q3 7.8% · Q4 6.2% · 4Q avg 7.4% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.0% |
1.3%
0.7 pts worse
|
1.0%
1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 1.1% · Q2 1.9% · Q3 2.8% · Q4 2.2% · 4Q avg 2.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 3.0% |
2.6%
0.4 pts worse
|
1.7%
1.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 1.9% · Q2 2.9% · Q3 2.8% · Q4 4.3% · 4Q avg 3.0% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 12.8% |
13.5%
0.7 pts better
|
19.8%
7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.1% · Q2 23.4% · Q3 11.6% · Q4 8.9% · 4Q avg 12.8% |
| Percentage of long-stay residents with pressure ulcers | 5.5% |
5.7%
0.2 pts better
|
5.1%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.1% · Q2 6.4% · Q3 5.6% · Q4 5.1% · 4Q avg 5.5% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 98.9% |
84.3%
14.6 pts better
|
81.7%
17.2 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 97.3% · Q2 98.9% · Q3 100.0% · Q4 99.4% · 4Q avg 98.9% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 13.4% |
11.5%
1.9 pts worse
|
12.0%
1.4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 13.4% · Observed 12.1% · Expected 10.1% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 3.1% |
2.1%
1 pts worse
|
1.6%
1.5 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 3.1% · Q2 1.2% · Q3 3.0% · Q4 4.7% · 4Q avg 3.1% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 93.4% |
80.3%
13.1 pts better
|
79.7%
13.7 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 93.4% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 26.4% |
24.5%
1.9 pts worse
|
23.9%
2.5 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 26.4% · Observed 22.0% · Expected 19.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2019-03-20 · Fire 2019-03-20
2 health deficiencies
Top issue: Infection Control (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2018-02-15 · Fire 2018-02-15
5 health deficiencies
Top issue: Nutrition and Dietary (2 deficiencies)
3 fire-safety deficiencies
Top issue: Emergency Preparedness (3 deficiencies)
Fire safety
Fire-safety citations
C · Minimal harm
2018-02-15
E29 · Emergency Preparedness Deficiencies
Fire Safety
Develop a communication plan.
Corrected 2018-03-07
C · Minimal harm
2018-02-15
E36 · Emergency Preparedness Deficiencies
Fire Safety
Establish emergency prep training and testing.
Corrected 2018-03-07
C · Minimal harm
2018-02-15
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2018-03-07
Inspection history
Recent health citations
F · Potential for more than minimal harm
2020-02-13
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2020-03-19
D · Potential for more than minimal harm
2020-02-13
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2020-03-19
D · Potential for more than minimal harm
2020-02-13
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2020-03-19
F · Potential for more than minimal harm
2019-03-20
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2019-04-24
D · Potential for more than minimal harm
2019-03-20
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2019-04-24
F · Potential for more than minimal harm
2018-02-15
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2018-03-22
D · Potential for more than minimal harm
2018-02-15
F554 · Resident Rights Deficiencies
Health
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected 2018-03-22
D · Potential for more than minimal harm
2018-02-15
F690 · Quality of Life and Care Deficiencies
Health
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected 2018-03-22
D · Potential for more than minimal harm
2018-02-15
F803 · Nutrition and Dietary Deficiencies
Health
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Corrected 2018-03-22
D · Potential for more than minimal harm
2018-02-15
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2018-03-22
Penalties and ownership
What sits behind the stars
Ownership
Walker, James
5% Or Greater Direct Ownership Interest · Individual
Bowling, Sherry
W-2 Managing Employee · Individual
Hanserd, Matthew
Contracted Managing Employee · Individual
Preston Health Services Inc
Operational/Managerial Control · Organization
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#2
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4-star overall rating with 3-star inspections with 5 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#3
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