Fort Worth Center Of Rehabilitation - Fort Worth Nursing Home
General Information
UPDATEFederal Provider Number
676255
Provider Name
FORT WORTH CENTER OF REHABILITATION
Provider Address
850 12TH AVENUE
FORT WORTH, TX 76104
FORT WORTH, TX 76104
Provider Phone Number
(817) 882-8289
Provider SSA County
910
Provider County Name
Tarrant
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
136
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DECATUR HOSPITAL AUTHORITY
Date First Approved to Provide Medicare and Medicaid services
2010-07-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
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
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.27320
Reported LPN Staffing Hours per Resident per Day
1.11392
Reported RN Staffing Hours per Resident per Day
0.67268
Reported Licensed Staffing Hours per Resident per Day
1.78660
Reported Total Nurse Staffing Hours per Resident per Day
4.05980
Reported Physical Therapist Staffing Hours per Resident Per Day
0.20825
Expected CNA Staffing Hours per Resident per Day
2.29219
Expected LPN Staffing Hours per Resident per Day
0.63357
Expected RN Staffing Hours per Resident per Day
1.26900
Expected Total Nurse Staffing Hours per Resident per Day
4.19476
Adjusted CNA Staffing Hours per Resident per Day
2.43337
Adjusted LPN Staffing Hours per Resident per Day
1.45928
Adjusted RN Staffing Hours per Resident per Day
0.39608
Adjusted Total Nurse Staffing Hours per Resident per Day
3.90121
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-07-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
144
Cycle 2 Standard Health Survey Date
2013-07-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
144
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
10
Cycle 3 Health Deficiency Score
413
Cycle 3 Standard Health Survey Date
2012-06-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
413
Total Weighted Health Survey Score
128.83300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
12
Number of Fines
3
Total Amount of Fines in Dollars
9500
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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