Retama Manor Nursing Center/san Antonio West - San Antonio Nursing Home
General Information
UPDATEFederal Provider Number
675002
Provider Name
RETAMA MANOR NURSING CENTER/SAN ANTONIO WEST
Provider Address
636 CUPPLES RD
SAN ANTONIO, TX 78237
SAN ANTONIO, TX 78237
Provider Phone Number
2104340611
Provider SSA County
130
Provider County Name
Bexar
Ownership Type
For profit - Corporation
Number of Certified Beds
139
Number of Residents in Certified Beds
111
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC SAN ANTONIO WEST OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1992-01-15
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
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
1.60631
Reported LPN Staffing Hours per Resident per Day
0.83243
Reported RN Staffing Hours per Resident per Day
0.15766
Reported Licensed Staffing Hours per Resident per Day
0.99009
Reported Total Nurse Staffing Hours per Resident per Day
2.59640
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.34321
Expected LPN Staffing Hours per Resident per Day
0.65599
Expected RN Staffing Hours per Resident per Day
1.08589
Expected Total Nurse Staffing Hours per Resident per Day
4.08509
Adjusted CNA Staffing Hours per Resident per Day
1.68205
Adjusted LPN Staffing Hours per Resident per Day
1.05324
Adjusted RN Staffing Hours per Resident per Day
0.10849
Adjusted Total Nurse Staffing Hours per Resident per Day
2.56196
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-11-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-09-20
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
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-09-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
71.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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