Edward Abraham Memorial Home Inc - Canadian Nursing Home
General Information
UPDATEFederal Provider Number
45F603
Provider Name
EDWARD ABRAHAM MEMORIAL HOME INC
Provider Address
803 BIRCH ST
CANADIAN, TX 79014
CANADIAN, TX 79014
Provider Phone Number
8063236453
Provider SSA County
632
Provider County Name
Hemphill
Ownership Type
Non profit - Corporation
Number of Certified Beds
49
Number of Residents in Certified Beds
22
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2008-01-01
Continuing Care Retirement Community
N
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.76591
Reported LPN Staffing Hours per Resident per Day
1.11364
Reported RN Staffing Hours per Resident per Day
0.78864
Reported Licensed Staffing Hours per Resident per Day
1.90227
Reported Total Nurse Staffing Hours per Resident per Day
4.66819
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.05432
Expected LPN Staffing Hours per Resident per Day
0.55008
Expected RN Staffing Hours per Resident per Day
0.69720
Expected Total Nurse Staffing Hours per Resident per Day
3.30159
Adjusted CNA Staffing Hours per Resident per Day
3.30363
Adjusted LPN Staffing Hours per Resident per Day
1.68035
Adjusted RN Staffing Hours per Resident per Day
0.84520
Adjusted Total Nurse Staffing Hours per Resident per Day
5.69938
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-03-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
204
Cycle 2 Standard Health Survey Date
2014-04-02
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2013-05-08
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
38
Cycle 3 Total Health Score
114
Total Weighted Health Survey Score
99.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
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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