Heritage Nursing Center - Haynesville Nursing Home
General Information
UPDATEFederal Provider Number
195518
Provider Name
HERITAGE NURSING CENTER
Provider Address
1745 BAILEY AVENUE
HAYNESVILLE, LA 71038
HAYNESVILLE, LA 71038
Provider Phone Number
(318) 624-1166
Provider SSA County
130
Provider County Name
Claiborne
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
82
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRI-STATE HEALTH SERVICES OF CENLA, LLC
Date First Approved to Provide Medicare and Medicaid services
2001-03-22
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.76455
Reported LPN Staffing Hours per Resident per Day
1.23636
Reported RN Staffing Hours per Resident per Day
0.23000
Reported Licensed Staffing Hours per Resident per Day
1.46636
Reported Total Nurse Staffing Hours per Resident per Day
4.23091
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02455
Expected CNA Staffing Hours per Resident per Day
2.17477
Expected LPN Staffing Hours per Resident per Day
0.61885
Expected RN Staffing Hours per Resident per Day
1.07102
Expected Total Nurse Staffing Hours per Resident per Day
3.86464
Adjusted CNA Staffing Hours per Resident per Day
3.11913
Adjusted LPN Staffing Hours per Resident per Day
1.65819
Adjusted RN Staffing Hours per Resident per Day
0.16046
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41293
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
16
Cycle 1 Standard Survey Health Date
2014-04-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-05-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-06-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
20.00000
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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