Country Village Care - Angleton Nursing Home
General Information
UPDATEFederal Provider Number
675696
Provider Name
COUNTRY VILLAGE CARE
Provider Address
721 W MULBERRY
ANGLETON, TX 77515
ANGLETON, TX 77515
Provider Phone Number
(979) 849-8281
Provider SSA County
180
Provider County Name
Brazoria
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
136
Number of Residents in Certified Beds
64
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
1997-07-15
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
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
3.25156
Reported LPN Staffing Hours per Resident per Day
1.11172
Reported RN Staffing Hours per Resident per Day
0.50625
Reported Licensed Staffing Hours per Resident per Day
1.61797
Reported Total Nurse Staffing Hours per Resident per Day
4.86953
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09844
Expected CNA Staffing Hours per Resident per Day
2.68084
Expected LPN Staffing Hours per Resident per Day
0.67330
Expected RN Staffing Hours per Resident per Day
1.08720
Expected Total Nurse Staffing Hours per Resident per Day
4.44134
Adjusted CNA Staffing Hours per Resident per Day
2.97607
Adjusted LPN Staffing Hours per Resident per Day
1.37045
Adjusted RN Staffing Hours per Resident per Day
0.34793
Adjusted Total Nurse Staffing Hours per Resident per Day
4.41952
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-03-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
14.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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