Bonner Street Plaza Healthcare & Rehabilitation - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
676092
Provider Name
BONNER STREET PLAZA HEALTHCARE & REHABILITATION
Provider Address
421 S BONNER
JACKSONVILLE, TX 75766
JACKSONVILLE, TX 75766
Provider Phone Number
(903) 586-9871
Provider SSA County
281
Provider County Name
Cherokee
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
84
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOUTHWEST LTC - BONNER, LLC
Date First Approved to Provide Medicare and Medicaid services
2006-04-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.32872
Reported LPN Staffing Hours per Resident per Day
1.04255
Reported RN Staffing Hours per Resident per Day
0.66170
Reported Licensed Staffing Hours per Resident per Day
1.70426
Reported Total Nurse Staffing Hours per Resident per Day
4.03297
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12340
Expected CNA Staffing Hours per Resident per Day
2.26261
Expected LPN Staffing Hours per Resident per Day
0.61195
Expected RN Staffing Hours per Resident per Day
1.10896
Expected Total Nurse Staffing Hours per Resident per Day
3.98352
Adjusted CNA Staffing Hours per Resident per Day
2.52540
Adjusted LPN Staffing Hours per Resident per Day
1.41403
Adjusted RN Staffing Hours per Resident per Day
0.44584
Adjusted Total Nurse Staffing Hours per Resident per Day
4.08094
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-04-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-04-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2013-03-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
50.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
7
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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