Cypress Glen - Port Arthur Nursing Home
General Information
UPDATEFederal Provider Number
675839
Provider Name
CYPRESS GLEN
Provider Address
7200 NINTH AVE
PORT ARTHUR, TX 77642
PORT ARTHUR, TX 77642
Provider Phone Number
(409) 729-8701
Provider SSA County
700
Provider County Name
Jefferson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
188
Number of Residents in Certified Beds
136
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PM MANAGEMENT - GOLDEN TRIANGLE NC III LLC
Date First Approved to Provide Medicare and Medicaid services
2000-08-25
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
2.54301
Reported LPN Staffing Hours per Resident per Day
1.21912
Reported RN Staffing Hours per Resident per Day
0.35662
Reported Licensed Staffing Hours per Resident per Day
1.57574
Reported Total Nurse Staffing Hours per Resident per Day
4.11875
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04449
Expected CNA Staffing Hours per Resident per Day
2.20463
Expected LPN Staffing Hours per Resident per Day
0.60374
Expected RN Staffing Hours per Resident per Day
1.10787
Expected Total Nurse Staffing Hours per Resident per Day
3.91624
Adjusted CNA Staffing Hours per Resident per Day
2.83031
Adjusted LPN Staffing Hours per Resident per Day
1.67601
Adjusted RN Staffing Hours per Resident per Day
0.24052
Adjusted Total Nurse Staffing Hours per Resident per Day
4.23934
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-08-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-09-11
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
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
112
Cycle 3 Standard Health Survey Date
2012-10-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
112
Total Weighted Health Survey Score
67.33300
Number of Facility Reported Incidents
3
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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