Louisiana Nursing Homes >> Shreveport Nursing Homes >> Heritage Manor South

Heritage Manor South - Shreveport Nursing Home

General Information

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Federal Provider Number
195408
Provider Name
HERITAGE MANOR SOUTH
Provider Address
9712 MANSFIELD ROAD
SHREVEPORT, LA 71118
Provider Phone Number
(318) 687-2080
Provider SSA County
80
Provider County Name
Caddo
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
145
Number of Residents in Certified Beds
128
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COMMUNITY CARE CENTER SHREVEPORT SOUTH, LLC
Date First Approved to Provide Medicare and Medicaid services
1997-04-01
Continuing Care Retirement Community
N
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
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
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
1.88398
Reported LPN Staffing Hours per Resident per Day
0.74727
Reported RN Staffing Hours per Resident per Day
0.42188
Reported Licensed Staffing Hours per Resident per Day
1.16914
Reported Total Nurse Staffing Hours per Resident per Day
3.05313
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04453
Expected CNA Staffing Hours per Resident per Day
2.54745
Expected LPN Staffing Hours per Resident per Day
0.63134
Expected RN Staffing Hours per Resident per Day
0.92662
Expected Total Nurse Staffing Hours per Resident per Day
4.10541
Adjusted CNA Staffing Hours per Resident per Day
1.81465
Adjusted LPN Staffing Hours per Resident per Day
0.98241
Adjusted RN Staffing Hours per Resident per Day
0.34019
Adjusted Total Nurse Staffing Hours per Resident per Day
2.99772
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-03-27
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
2013-04-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
323
Cycle 3 Standard Health Survey Date
2012-05-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
323
Total Weighted Health Survey Score
55.16700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
3
Total Amount of Fines in Dollars
6204
Number of Payment Denials
1
Total Number of Penalties
4
Location
Processing Date
2015-06-01
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