Country Care Manor - La Vernia Nursing Home
General Information
UPDATEFederal Provider Number
675947
Provider Name
COUNTRY CARE MANOR
Provider Address
2736 FARM TO MARKET 775
LA VERNIA, TX 78121
LA VERNIA, TX 78121
Provider Phone Number
(830) 779-2355
Provider SSA County
971
Provider County Name
Wilson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
91
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2002-12-04
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
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
1.85282
Reported LPN Staffing Hours per Resident per Day
0.39859
Reported RN Staffing Hours per Resident per Day
0.42183
Reported Licensed Staffing Hours per Resident per Day
0.82042
Reported Total Nurse Staffing Hours per Resident per Day
2.67324
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07817
Expected CNA Staffing Hours per Resident per Day
2.42016
Expected LPN Staffing Hours per Resident per Day
0.65005
Expected RN Staffing Hours per Resident per Day
1.09821
Expected Total Nurse Staffing Hours per Resident per Day
4.16842
Adjusted CNA Staffing Hours per Resident per Day
1.87850
Adjusted LPN Staffing Hours per Resident per Day
0.50893
Adjusted RN Staffing Hours per Resident per Day
0.28700
Adjusted Total Nurse Staffing Hours per Resident per Day
2.58505
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-03-08
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
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-01-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
36.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
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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