Ambrosio Guillen Texas State Veterans Home - El Paso Nursing Home
General Information
UPDATEFederal Provider Number
676060
Provider Name
AMBROSIO GUILLEN TEXAS STATE VETERANS HOME
Provider Address
9650 KENWORTHY ST
EL PASO, TX 79924
EL PASO, TX 79924
Provider Phone Number
9157510967
Provider SSA County
480
Provider County Name
El Paso
Ownership Type
Government - State
Number of Certified Beds
160
Number of Residents in Certified Beds
151
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
STATE OF TEXAS VETERANS LAND BOARD
Date First Approved to Provide Medicare and Medicaid services
2005-08-03
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
1
Overall Rating Footnote
Health Inspection Rating
1
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
2.53344
Reported LPN Staffing Hours per Resident per Day
0.93377
Reported RN Staffing Hours per Resident per Day
0.27616
Reported Licensed Staffing Hours per Resident per Day
1.20993
Reported Total Nurse Staffing Hours per Resident per Day
3.74337
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01026
Expected CNA Staffing Hours per Resident per Day
2.18239
Expected LPN Staffing Hours per Resident per Day
0.59853
Expected RN Staffing Hours per Resident per Day
0.94770
Expected Total Nurse Staffing Hours per Resident per Day
3.72862
Adjusted CNA Staffing Hours per Resident per Day
2.84839
Adjusted LPN Staffing Hours per Resident per Day
1.29489
Adjusted RN Staffing Hours per Resident per Day
0.21773
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04685
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
364
Cycle 1 Standard Survey Health Date
2014-10-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
364
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
15
Cycle 2 Health Deficiency Score
584
Cycle 2 Standard Health Survey Date
2013-11-05
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
378.00000
Number of Facility Reported Incidents
7
Number of Substantiated Complaints
0
Number of Fines
3
Total Amount of Fines in Dollars
127113
Number of Payment Denials
3
Total Number of Penalties
6
Location
Processing Date
2015-06-01
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