Centerville Healthcare Center - Centerville Nursing Home
General Information
UPDATEFederal Provider Number
675065
Provider Name
CENTERVILLE HEALTHCARE CENTER
Provider Address
103 TEAKWOOD ST
CENTERVILLE, TX 75833
CENTERVILLE, TX 75833
Provider Phone Number
9035362596
Provider SSA County
756
Provider County Name
Leon
Ownership Type
For profit - Corporation
Number of Certified Beds
96
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1992-06-25
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.76429
Reported LPN Staffing Hours per Resident per Day
0.99464
Reported RN Staffing Hours per Resident per Day
0.45179
Reported Licensed Staffing Hours per Resident per Day
1.44643
Reported Total Nurse Staffing Hours per Resident per Day
3.21072
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.25835
Expected LPN Staffing Hours per Resident per Day
0.67400
Expected RN Staffing Hours per Resident per Day
1.03417
Expected Total Nurse Staffing Hours per Resident per Day
3.96651
Adjusted CNA Staffing Hours per Resident per Day
1.91690
Adjusted LPN Staffing Hours per Resident per Day
1.22486
Adjusted RN Staffing Hours per Resident per Day
0.32642
Adjusted Total Nurse Staffing Hours per Resident per Day
3.26284
Cycle 1 Total Number of Health Deficiencies
20
Cycle 1 Number of Standard Health Deficiencies
20
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
352
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
352
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-05-01
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-03-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
190.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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