Carriage House Manor - Sulphur Springs Nursing Home
General Information
UPDATEFederal Provider Number
675181
Provider Name
CARRIAGE HOUSE MANOR
Provider Address
210 PIPELINE RD
SULPHUR SPRINGS, TX 75482
SULPHUR SPRINGS, TX 75482
Provider Phone Number
(903) 885-3589
Provider SSA County
654
Provider County Name
Hopkins
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARRIAGE HOUSE MANOR INC
Date First Approved to Provide Medicare and Medicaid services
1993-07-12
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
3.17570
Reported LPN Staffing Hours per Resident per Day
0.79393
Reported RN Staffing Hours per Resident per Day
0.39720
Reported Licensed Staffing Hours per Resident per Day
1.19112
Reported Total Nurse Staffing Hours per Resident per Day
4.36683
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04813
Expected CNA Staffing Hours per Resident per Day
2.53233
Expected LPN Staffing Hours per Resident per Day
0.63464
Expected RN Staffing Hours per Resident per Day
0.96199
Expected Total Nurse Staffing Hours per Resident per Day
4.12896
Adjusted CNA Staffing Hours per Resident per Day
3.07709
Adjusted LPN Staffing Hours per Resident per Day
1.03833
Adjusted RN Staffing Hours per Resident per Day
0.30851
Adjusted Total Nurse Staffing Hours per Resident per Day
4.26312
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-09-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
184
Cycle 2 Standard Health Survey Date
2013-11-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
184
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-11-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
78.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
5
Number of Fines
1
Total Amount of Fines in Dollars
2275
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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