Arbor Grace Skilled Nursing And Rehabilitation Llc - Kilgore Nursing Home
General Information
UPDATEFederal Provider Number
676322
Provider Name
ARBOR GRACE SKILLED NURSING AND REHABILITATION LLC
Provider Address
144 FM 1252 WEST
KILGORE, TX 75662
KILGORE, TX 75662
Provider Phone Number
(903) 984-5688
Provider SSA County
570
Provider County Name
Gregg
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
59
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ARBOR GRACE SKILLED NURSING AND REHABILITATION LLC
Date First Approved to Provide Medicare and Medicaid services
2012-11-29
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.61625
Reported LPN Staffing Hours per Resident per Day
1.18000
Reported RN Staffing Hours per Resident per Day
0.50375
Reported Licensed Staffing Hours per Resident per Day
1.68375
Reported Total Nurse Staffing Hours per Resident per Day
4.30000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00750
Expected CNA Staffing Hours per Resident per Day
2.55248
Expected LPN Staffing Hours per Resident per Day
0.68788
Expected RN Staffing Hours per Resident per Day
1.02965
Expected Total Nurse Staffing Hours per Resident per Day
4.27001
Adjusted CNA Staffing Hours per Resident per Day
2.51500
Adjusted LPN Staffing Hours per Resident per Day
1.42380
Adjusted RN Staffing Hours per Resident per Day
0.36556
Adjusted Total Nurse Staffing Hours per Resident per Day
4.05921
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-07-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
259
Cycle 2 Standard Health Survey Date
2013-09-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
259
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-11-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
125.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
3
Total Amount of Fines in Dollars
10276
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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