Estates Healthcare And Rehabilitation Center - Fort Worth Nursing Home
General Information
UPDATEFederal Provider Number
675028
Provider Name
ESTATES HEALTHCARE AND REHABILITATION CENTER
Provider Address
201 SYCAMORE SCHOOL RD
FORT WORTH, TX 76134
FORT WORTH, TX 76134
Provider Phone Number
(817) 293-7610
Provider SSA County
910
Provider County Name
Tarrant
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
143
Number of Residents in Certified Beds
112
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DIVERSICARE ESTATES LLC
Date First Approved to Provide Medicare and Medicaid services
1991-12-01
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.80045
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.78973
Reported Licensed Staffing Hours per Resident per Day
0.78973
Reported Total Nurse Staffing Hours per Resident per Day
3.59018
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17232
Expected CNA Staffing Hours per Resident per Day
2.65277
Expected LPN Staffing Hours per Resident per Day
0.61422
Expected RN Staffing Hours per Resident per Day
1.01050
Expected Total Nurse Staffing Hours per Resident per Day
4.27750
Adjusted CNA Staffing Hours per Resident per Day
2.59030
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.58395
Adjusted Total Nurse Staffing Hours per Resident per Day
3.38321
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-07-10
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-07-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
499
Cycle 3 Standard Health Survey Date
2012-06-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
499
Total Weighted Health Survey Score
116.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
Number of Fines
2
Total Amount of Fines in Dollars
120153
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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