SNF
Collierville Nursing And Rehabilitation, Llc
CCN: 445495 · COLLIERVILLE, TN 38017 · Shelby County
Inspection > 2 years ago
Overview
- Address
- 490 WEST POPLAR AVENUE, COLLIERVILLE, TN 38017
- Phone
- 9018548506
- Certified beds
- 114
- Avg daily residents
- 85 (74% of beds filled)
- Ownership
- For-profit LLC
- Provider type
- Medicare and Medicaid
- Medicare/Medicaid since
- 2009-07-07
- Setting
- Urban
1 /5
★★★★★
CMS Overall Rating
CMS 5-Star Ratings
CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.
Staffing & Workforce
Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.
| Role | Reported | Case-mix expected | Adjusted | Federal floor | |
|---|---|---|---|---|---|
| Total nurse All nursing staff combined: RN + LPN + Aide | 3.24 | 3.97 | 3.15 | ≥ 3.48 | Below floor |
| Registered Nurse (RN) Licensed RN hours. Strongest driver of clinical outcomes. | 0.37 | 0.69 | 0.36 | ≥ 0.55 | Below floor |
| Licensed Practical Nurse (LPN) LPN/LVN hours. Often handles medication administration. | 1.23 | 0.88 | 1.20 | — | |
| Nurse aide CNA hours. Bulk of direct resident care — bathing, feeding, mobility. | 1.64 | 2.39 | 1.60 | — | |
| Licensed (RN + LPN) Combined licensed nurse coverage. | 1.59 | — | — | — | |
| Physical therapist Rehabilitation therapist hours — important for post-acute / rehab admissions. | 0.07 | — | — | — |
Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.
Weekend staffing
Total nurse (weekend)
2.81
hrs / resident / day
RN (weekend)
0.23
hrs / resident / day
Total nurse (adjusted, weekend)
2.73
hrs / resident / day
Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.
Staff turnover
Total nursing staff turnover
56.1%
annual
RN turnover
61.5%
annual
Administrators departed
New facility — insufficient data.
Resident acuity
Nursing Case-Mix Index
1.41
higher acuity than avg
Case-Mix Index Ratio
1.02
facility / state ratio
Health Inspections
CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.
| Cycle | Date | Total defs. | Standard | Complaint | Deficiency score | Revisits | Total score |
|---|---|---|---|---|---|---|---|
| Cycle 1 (most recent) | 2022-02-25 | 9 | 8 | 1 | 52 | 1 | 52 |
| Cycle 2/3 (prior) | 2019-12-11 | 13 | 13 | 0 | 68 | 1 | 68 |
Total weighted health score
56.0
lower is better
Deficiencies (26)
Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).
26 D/E/F Actual harm — potential for minor
| Tag | Description | Scope/Severity | Survey date | Corrected |
|---|---|---|---|---|
| 0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-11-18 | 2025-11-21 |
| 0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | 2022-02-25 | 2022-04-01 |
| 0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | 2022-02-25 | 2022-04-01 |
| 0641 | Ensure each resident receives an accurate assessment. | D | 2022-02-25 | 2022-04-01 |
| 0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2022-02-25 | 2022-04-01 |
| 0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | 2022-02-25 | 2022-04-01 |
| 0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | 2022-02-25 | 2022-04-01 |
| 0791 | Provide or obtain dental services for each resident. | D | 2022-02-25 | 2022-04-01 |
| 0880 | Provide and implement an infection prevention and control program. | F | 2022-02-25 | 2022-04-01 |
| 0569 | Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | D | 2019-12-11 | 2020-01-04 |
| 0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | 2019-12-11 | 2020-01-04 |
| 0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | 2019-12-11 | 2020-01-04 |
| 0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | E | 2019-12-11 | 2020-01-04 |
| 0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2019-12-11 | 2020-01-04 |
| 0679 | Provide activities to meet all resident's needs. | D | 2019-12-11 | 2020-01-04 |
| 0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | 2019-12-11 | 2020-01-04 |
| 0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | 2019-12-11 | 2020-01-04 |
| 0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | 2019-12-11 | 2020-01-04 |
| 0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | 2019-12-11 | 2020-01-04 |
| 0759 | Ensure medication error rates are not 5 percent or greater. | E | 2019-12-11 | 2020-01-04 |
| 0761 | 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. | E | 2019-12-11 | 2020-01-04 |
| 0880 | Provide and implement an infection prevention and control program. | E | 2019-12-11 | 2020-01-04 |
| 0659 | Provide care by qualified persons according to each resident's written plan of care. | D | 2019-02-06 | 2019-03-15 |
| 0692 | Provide enough food/fluids to maintain a resident's health. | D | 2019-02-06 | 2019-03-15 |
| 0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | 2019-02-06 | 2019-03-15 |
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | 2019-02-06 | 2019-03-15 |
Financial Health (FY 2023)
Payer mix (share of resident days)
Medicare 8.8% Medicaid 67.3% Other 23.9%
Operating performance
Operating Margin
-8.4%
Total Margin
-3.9%
Occupancy Rate
64.3%
Cost per Resident Day
$41
Revenue & costs
Net Patient Revenue
$8.5M
Total Costs
$1.1M
Net Income
-$349K
Balance sheet
Total Assets
-$2.6M
Total Liabilities
$1.4M
Fund Balance
-$4.0M
Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.
Ownership & Corporate Structure
Chain: SIMCHA HYMAN & NAFTALI ZANZIPER
- Chain ID
580- Facilities in chain
- 94
- Legal business name
- COLLIERVILLE NURSING AND REHABILITATION LLC
Chain-average star ratings (for peer context)
Overall
2.3
Health
2.5
Staffing
2.3
QM
3.0
Owner / manager organizations (2)
| Organization | Role | Association |
|---|---|---|
| COLLIERVILLE NURSING AND REHABILITATION LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | since 10/13/2018 |
| CLEARVIEW HEALTHCARE MANAGEMENT TN LLC | OPERATIONAL/MANAGERIAL CONTROL | since 12/01/2021 |
Owner / manager individuals (5)
| Name | Role | Association |
|---|---|---|
| HYMAN, SIMCHA | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 10/13/2018 |
| ZANZIPER, NAFTALI | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | since 10/13/2018 |
| VUJANOVIC, MICK | OPERATIONAL/MANAGERIAL CONTROL | since 10/12/2018 |
| VUJANOVIC, MICK | CORPORATE OFFICER | since 10/12/2018 |
| SHELTON, GAYLE | W-2 MANAGING EMPLOYEE | since 08/05/2024 |
Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.
Facility Features
- CCRC
- No
- Hospital-based
- No
- Resident / family council
- Resident
- Sprinkler systems
- Yes
- Abuse citation flag
- No
Methodology & sources
- Nursing Home Provider Info (
nh-provider-info), vintage 2026, downloaded 2026-04-14 , 14,703 rows. - Nursing Home Health Deficiencies (
nh-deficiencies), vintage 2026, downloaded 2026-04-14 , 418,972 rows. - Nursing Home Ownership (
nh-ownership), vintage 2026, downloaded 2026-04-14 , 160,393 rows. - Skilled Nursing Facility Cost Report (
snf-cost-report), vintage 2023, downloaded 2026-04-14 , 14,120 rows.
All Data
Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.
Show 112 rows
| Source | Metric | Value | Raw key |
|---|---|---|---|
| Cost Report | Cost per Resident Day ($) | $41 | metrics.cost_per_resident_day |
| Cost Report | fiscal_year | 2,023 | fiscal_year |
| Cost Report | Medicaid Day Share (%) | 67.3% | metrics.medicaid_day_share |
| Cost Report | Medicare Day Share (%) | 8.8% | metrics.medicare_day_share |
| Cost Report | Net Income ($) | $-348,555 | metrics.net_income |
| Cost Report | Net Patient Revenue ($) | $8,501,249 | metrics.net_patient_revenue |
| Cost Report | Occupancy Rate (%) | 64.3% | metrics.occupancy_rate |
| Cost Report | Operating Margin (%) | -8.4% | metrics.operating_margin |
| Cost Report | Total Assets ($) | $-2,602,458 | metrics.total_assets |
| Cost Report | Total Costs ($) | $1,094,638 | metrics.total_costs |
| Cost Report | Total Fund Balances ($) | $-4,042,956 | metrics.fund_balance |
| Cost Report | Total Liabilities ($) | $1,440,498 | metrics.total_liabilities |
| Cost Report | Total Margin (%) | -3.9% | metrics.total_margin |
| Provider Information | Abuse Icon | N | Abuse Icon |
| Provider Information | Adjusted LPN Staffing Hours per Resident per Day | 1.19677 | Adjusted LPN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Nurse Aide Staffing Hours per Resident per Day | 1.59797 | Adjusted Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Adjusted RN Staffing Hours per Resident per Day | 0.35541 | Adjusted RN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Total Nurse Staffing Hours per Resident per Day | 3.15015 | Adjusted Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day | 2.73101 | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Administrator turnover footnote | 26 | Administrator turnover footnote |
| Provider Information | Automatic Sprinkler Systems in All Required Areas | Yes | Automatic Sprinkler Systems in All Required Areas |
| Provider Information | Average Number of Residents per Day | 84.5 | Average Number of Residents per Day |
| Provider Information | Average Number of Residents per Day Footnote | — | Average Number of Residents per Day Footnote |
| Provider Information | Case-Mix LPN Staffing Hours per Resident per Day | 0.88041 | Case-Mix LPN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Nurse Aide Staffing Hours per Resident per Day | 2.39277 | Case-Mix Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Case-Mix RN Staffing Hours per Resident per Day | 0.69396 | Case-Mix RN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Total Nurse Staffing Hours per Resident per Day | 3.96714 | Case-Mix Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day | 3.49661 | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Chain Average Health Inspection Rating | 2.5 | Chain Average Health Inspection Rating |
| Provider Information | Chain Average Overall 5-star Rating | 2.3 | Chain Average Overall 5-star Rating |
| Provider Information | Chain Average QM Rating | 3.0 | Chain Average QM Rating |
| Provider Information | Chain Average Staffing Rating | 2.3 | Chain Average Staffing Rating |
| Provider Information | Chain ID | 580 | Chain ID |
| Provider Information | Chain Name | SIMCHA HYMAN & NAFTALI ZANZIPER | Chain Name |
| Provider Information | City/Town | COLLIERVILLE | City/Town |
| Provider Information | CMS Certification Number (CCN) | 445495 | CMS Certification Number (CCN) |
| Provider Information | Continuing Care Retirement Community | N | Continuing Care Retirement Community |
| Provider Information | County/Parish | Shelby | County/Parish |
| Provider Information | Date First Approved to Provide Medicare and Medicaid Services | 2009-07-07 | Date First Approved to Provide Medicare and Medicaid Services |
| Provider Information | Geocoding Footnote | 22 | Geocoding Footnote |
| Provider Information | Health Inspection Rating | 2 | Health Inspection Rating |
| Provider Information | Health Inspection Rating Footnote | — | Health Inspection Rating Footnote |
| Provider Information | Latitude | 35.0541 | Latitude |
| Provider Information | Legal Business Name | COLLIERVILLE NURSING AND REHABILITATION LLC | Legal Business Name |
| Provider Information | Location | 490 WEST POPLAR AVENUE,COLLIERVILLE,TN,38017 | Location |
| Provider Information | Long-Stay QM Rating | 3 | Long-Stay QM Rating |
| Provider Information | Long-Stay QM Rating Footnote | — | Long-Stay QM Rating Footnote |
| Provider Information | Longitude | -89.679 | Longitude |
| Provider Information | Most Recent Health Inspection More Than 2 Years Ago | Y | Most Recent Health Inspection More Than 2 Years Ago |
| Provider Information | Number of administrators who have left the nursing home | — | Number of administrators who have left the nursing home |
| Provider Information | Number of Certified Beds | 114 | Number of Certified Beds |
| Provider Information | Number of Citations from Infection Control Inspections | — | Number of Citations from Infection Control Inspections |
| Provider Information | Number of Facilities in Chain | 94 | Number of Facilities in Chain |
| Provider Information | Number of Fines | 0 | Number of Fines |
| Provider Information | Number of Payment Denials | 0 | Number of Payment Denials |
| Provider Information | Nursing Case-Mix Index | 1.40538 | Nursing Case-Mix Index |
| Provider Information | Nursing Case-Mix Index Ratio | 1.02013 | Nursing Case-Mix Index Ratio |
| Provider Information | Overall Rating | 1 | Overall Rating |
| Provider Information | Overall Rating Footnote | — | Overall Rating Footnote |
| Provider Information | Ownership Type | For profit - Limited Liability company | Ownership Type |
| Provider Information | Physical Therapist Staffing Footnote | — | Physical Therapist Staffing Footnote |
| Provider Information | Processing Date | 2026-03-01 | Processing Date |
| Provider Information | Provider Address | 490 WEST POPLAR AVENUE | Provider Address |
| Provider Information | Provider Changed Ownership in Last 12 Months | N | Provider Changed Ownership in Last 12 Months |
| Provider Information | Provider Name | Collierville Nursing And Rehabilitation, Llc | Provider Name |
| Provider Information | Provider Resides in Hospital | N | Provider Resides in Hospital |
| Provider Information | Provider SSA County Code | 780 | Provider SSA County Code |
| Provider Information | Provider Type | Medicare and Medicaid | Provider Type |
| Provider Information | QM Rating | 2 | QM Rating |
| Provider Information | QM Rating Footnote | — | QM Rating Footnote |
| Provider Information | Rating Cycle 1 Health Deficiency Score | 52 | Rating Cycle 1 Health Deficiency Score |
| Provider Information | Rating Cycle 1 Health Revisit Score | 0 | Rating Cycle 1 Health Revisit Score |
| Provider Information | Rating Cycle 1 Number of Complaint Health Deficiencies | 1 | Rating Cycle 1 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 1 Number of Health Revisits | 1 | Rating Cycle 1 Number of Health Revisits |
| Provider Information | Rating Cycle 1 Number of Standard Health Deficiencies | 8 | Rating Cycle 1 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 1 Standard Survey Health Date | 2022-02-25 | Rating Cycle 1 Standard Survey Health Date |
| Provider Information | Rating Cycle 1 Total Health Score | 52 | Rating Cycle 1 Total Health Score |
| Provider Information | Rating Cycle 1 Total Number of Health Deficiencies | 9 | Rating Cycle 1 Total Number of Health Deficiencies |
| Provider Information | Rating Cycle 2 Number of Standard Health Deficiencies | 13 | Rating Cycle 2 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 2 Standard Health Survey Date | 2019-12-11 | Rating Cycle 2 Standard Health Survey Date |
| Provider Information | Rating Cycle 2/3 Health Deficiency Score | 68 | Rating Cycle 2/3 Health Deficiency Score |
| Provider Information | Rating Cycle 2/3 Health Revisit Score | 0 | Rating Cycle 2/3 Health Revisit Score |
| Provider Information | Rating Cycle 2/3 Number of Complaint Health Deficiencies | 0 | Rating Cycle 2/3 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 2/3 Number of Health Revisits | 1 | Rating Cycle 2/3 Number of Health Revisits |
| Provider Information | Rating Cycle 2/3 Total Health Score | 68 | Rating Cycle 2/3 Total Health Score |
| Provider Information | Rating Cycle 2/3 Total Number of Health Deficiencies | 13 | Rating Cycle 2/3 Total Number of Health Deficiencies |
| Provider Information | Registered Nurse hours per resident per day on the weekend | 0.22906 | Registered Nurse hours per resident per day on the weekend |
| Provider Information | Registered Nurse turnover | 61.5 | Registered Nurse turnover |
| Provider Information | Registered Nurse turnover footnote | — | Registered Nurse turnover footnote |
| Provider Information | Reported Licensed Staffing Hours per Resident per Day | 1.59488 | Reported Licensed Staffing Hours per Resident per Day |
| Provider Information | Reported LPN Staffing Hours per Resident per Day | 1.22969 | Reported LPN Staffing Hours per Resident per Day |
| Provider Information | Reported Nurse Aide Staffing Hours per Resident per Day | 1.64193 | Reported Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Reported Physical Therapist Staffing Hours per Resident Per Day | 0.06790 | Reported Physical Therapist Staffing Hours per Resident Per Day |
| Provider Information | Reported RN Staffing Hours per Resident per Day | 0.36519 | Reported RN Staffing Hours per Resident per Day |
| Provider Information | Reported Staffing Footnote | — | Reported Staffing Footnote |
| Provider Information | Reported Total Nurse Staffing Hours per Resident per Day | 3.23681 | Reported Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Short-Stay QM Rating | 2 | Short-Stay QM Rating |
| Provider Information | Short-Stay QM Rating Footnote | — | Short-Stay QM Rating Footnote |
| Provider Information | Special Focus Status | — | Special Focus Status |
| Provider Information | Staffing Rating | 1 | Staffing Rating |
| Provider Information | Staffing Rating Footnote | — | Staffing Rating Footnote |
| Provider Information | State | TN | State |
| Provider Information | Telephone Number | 9018548506 | Telephone Number |
| Provider Information | Total Amount of Fines in Dollars | 0.00 | Total Amount of Fines in Dollars |
| Provider Information | Total number of nurse staff hours per resident per day on the weekend | 2.80613 | Total number of nurse staff hours per resident per day on the weekend |
| Provider Information | Total Number of Penalties | 0 | Total Number of Penalties |
| Provider Information | Total nursing staff turnover | 56.1 | Total nursing staff turnover |
| Provider Information | Total nursing staff turnover footnote | — | Total nursing staff turnover footnote |
| Provider Information | Total Weighted Health Survey Score | 56.000 | Total Weighted Health Survey Score |
| Provider Information | Urban | Y | Urban |
| Provider Information | With a Resident and Family Council | Resident | With a Resident and Family Council |
| Provider Information | ZIP Code | 38017 | ZIP Code |