Healthcare Center At The Forum At Park Lane - Dallas Nursing Home
General Information
UPDATEFederal Provider Number
455913
Provider Name
HEALTHCARE CENTER AT THE FORUM AT PARK LANE
Provider Address
7827 PARK LN
DALLAS, TX 75225
DALLAS, TX 75225
Provider Phone Number
2143699905
Provider SSA County
390
Provider County Name
Dallas
Ownership Type
Government - Federal
Number of Certified Beds
38
Number of Residents in Certified Beds
41
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
FS TENANT POOL III TRUST
Date First Approved to Provide Medicare and Medicaid services
1991-02-07
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
3.44878
Reported LPN Staffing Hours per Resident per Day
2.13415
Reported RN Staffing Hours per Resident per Day
0.42073
Reported Licensed Staffing Hours per Resident per Day
2.55488
Reported Total Nurse Staffing Hours per Resident per Day
6.00366
Reported Physical Therapist Staffing Hours per Resident Per Day
0.39024
Expected CNA Staffing Hours per Resident per Day
2.25759
Expected LPN Staffing Hours per Resident per Day
0.57122
Expected RN Staffing Hours per Resident per Day
1.08410
Expected Total Nurse Staffing Hours per Resident per Day
3.91291
Adjusted CNA Staffing Hours per Resident per Day
3.74837
Adjusted LPN Staffing Hours per Resident per Day
3.10097
Adjusted RN Staffing Hours per Resident per Day
0.28998
Adjusted Total Nurse Staffing Hours per Resident per Day
6.18469
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-11-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-10-25
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
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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