Carillon Inc - Lubbock Nursing Home
General Information
UPDATEFederal Provider Number
675997
Provider Name
CARILLON INC
Provider Address
1717 A NORFOLK AVE
LUBBOCK, TX 79416
LUBBOCK, TX 79416
Provider Phone Number
8062816114
Provider SSA County
770
Provider County Name
Lubbock
Ownership Type
Non profit - Corporation
Number of Certified Beds
140
Number of Residents in Certified Beds
98
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
CARILLON, INC.
Date First Approved to Provide Medicare and Medicaid services
2003-12-17
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.52653
Reported LPN Staffing Hours per Resident per Day
1.52143
Reported RN Staffing Hours per Resident per Day
0.36122
Reported Licensed Staffing Hours per Resident per Day
1.88265
Reported Total Nurse Staffing Hours per Resident per Day
4.40918
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22092
Expected CNA Staffing Hours per Resident per Day
2.34478
Expected LPN Staffing Hours per Resident per Day
0.63919
Expected RN Staffing Hours per Resident per Day
1.17356
Expected Total Nurse Staffing Hours per Resident per Day
4.15753
Adjusted CNA Staffing Hours per Resident per Day
2.64389
Adjusted LPN Staffing Hours per Resident per Day
1.97562
Adjusted RN Staffing Hours per Resident per Day
0.22999
Adjusted Total Nurse Staffing Hours per Resident per Day
4.27488
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-01-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
44.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
715
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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