Country Club Nursing And Rehabilitation Lp - Amarillo Nursing Home
General Information
UPDATEFederal Provider Number
675282
Provider Name
COUNTRY CLUB NURSING AND REHABILITATION LP
Provider Address
9 MEDICAL DR
AMARILLO, TX 79106
AMARILLO, TX 79106
Provider Phone Number
(806) 352-2731
Provider SSA County
860
Provider County Name
Potter
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
102
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRY CLUB NURSING AND REHABILITATION LP
Date First Approved to Provide Medicare and Medicaid services
1994-04-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
1.67447
Reported LPN Staffing Hours per Resident per Day
0.95851
Reported RN Staffing Hours per Resident per Day
0.45000
Reported Licensed Staffing Hours per Resident per Day
1.40851
Reported Total Nurse Staffing Hours per Resident per Day
3.08298
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01064
Expected CNA Staffing Hours per Resident per Day
2.22814
Expected LPN Staffing Hours per Resident per Day
0.63337
Expected RN Staffing Hours per Resident per Day
1.13307
Expected Total Nurse Staffing Hours per Resident per Day
3.99457
Adjusted CNA Staffing Hours per Resident per Day
1.84398
Adjusted LPN Staffing Hours per Resident per Day
1.25609
Adjusted RN Staffing Hours per Resident per Day
0.29675
Adjusted Total Nurse Staffing Hours per Resident per Day
3.11102
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
136
Cycle 1 Standard Survey Health Date
2014-12-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
136
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2014-02-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-02-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
91.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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