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Cleveland Health Care Center - Cleveland Nursing Home

General Information

UPDATE
Federal Provider Number
455952
Provider Name
CLEVELAND HEALTH CARE CENTER
Provider Address
903 E HOUSTON ST
CLEVELAND, TX 77327
Provider Phone Number
(281) 593-3737
Provider SSA County
757
Provider County Name
Liberty
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
142
Number of Residents in Certified Beds
80
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HSMTX/CLEVELAND, LLC
Date First Approved to Provide Medicare and Medicaid services
1991-09-26
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
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
2.74938
Reported LPN Staffing Hours per Resident per Day
1.38313
Reported RN Staffing Hours per Resident per Day
0.34500
Reported Licensed Staffing Hours per Resident per Day
1.72813
Reported Total Nurse Staffing Hours per Resident per Day
4.47751
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.25955
Expected LPN Staffing Hours per Resident per Day
0.65845
Expected RN Staffing Hours per Resident per Day
1.05606
Expected Total Nurse Staffing Hours per Resident per Day
3.97405
Adjusted CNA Staffing Hours per Resident per Day
2.98562
Adjusted LPN Staffing Hours per Resident per Day
1.74350
Adjusted RN Staffing Hours per Resident per Day
0.24410
Adjusted Total Nurse Staffing Hours per Resident per Day
4.54156
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
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
40
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
40
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
24
Cycle 3 Standard Health Survey Date
2012-10-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
55.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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