Autumn Leaves - Dallas Nursing Home
General Information
UPDATEFederal Provider Number
675830
Provider Name
AUTUMN LEAVES
Provider Address
1010 EMERALD ISLE DR
DALLAS, TX 75218
DALLAS, TX 75218
Provider Phone Number
(214) 328-4161
Provider SSA County
390
Provider County Name
Dallas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
75
Number of Residents in Certified Beds
45
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
LCS AL LLC
Date First Approved to Provide Medicare and Medicaid services
2000-06-19
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
2.83333
Reported LPN Staffing Hours per Resident per Day
1.19667
Reported RN Staffing Hours per Resident per Day
1.22000
Reported Licensed Staffing Hours per Resident per Day
2.41667
Reported Total Nurse Staffing Hours per Resident per Day
5.25000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14000
Expected CNA Staffing Hours per Resident per Day
2.50392
Expected LPN Staffing Hours per Resident per Day
0.67815
Expected RN Staffing Hours per Resident per Day
1.18368
Expected Total Nurse Staffing Hours per Resident per Day
4.36575
Adjusted CNA Staffing Hours per Resident per Day
2.77650
Adjusted LPN Staffing Hours per Resident per Day
1.46464
Adjusted RN Staffing Hours per Resident per Day
0.77013
Adjusted Total Nurse Staffing Hours per Resident per Day
4.84733
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-01-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
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
2013-01-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
22.66700
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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