E F And Bertha Kruse Memorial Lutheran Village - Brenham Nursing Home
General Information
UPDATEFederal Provider Number
675837
Provider Name
E F AND BERTHA KRUSE MEMORIAL LUTHERAN VILLAGE
Provider Address
1700 E STONE ST
BRENHAM, TX 77833
BRENHAM, TX 77833
Provider Phone Number
(979) 830-1996
Provider SSA County
952
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
65
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN SOCIAL SERVICES OF THE SOUTH, INC.
Date First Approved to Provide Medicare and Medicaid services
2000-09-01
Continuing Care Retirement Community
Y
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
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
0
Staffing Rating Footnote
Data Not Available
RN Staffing Rating
0
RN Staffing Rating Footnote
Data Not Available
Reported Staffing Footnote
Staffing Values not Reported because of Data Quality Concerns
Physical Therapist Staffing Footnote
Physical Therapy Staffing Values not Reported because of Data Quality Concerns
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.00000
Reported Licensed Staffing Hours per Resident per Day
0.00000
Reported Total Nurse Staffing Hours per Resident per Day
0.00000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.43671
Expected LPN Staffing Hours per Resident per Day
0.58406
Expected RN Staffing Hours per Resident per Day
0.86291
Expected Total Nurse Staffing Hours per Resident per Day
3.88367
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
216
Cycle 1 Standard Survey Health Date
2015-01-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
216
Cycle 2 Total Number of Health Deficiencies
22
Cycle 2 Number of Standard Health Deficiencies
20
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
429
Cycle 2 Standard Health Survey Date
2013-12-20
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
215
Cycle 2 Total Health Score
644
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2012-10-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
338.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
2
Total Amount of Fines in Dollars
14283
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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