Interlochen Health And Rehabilitation Center - Arlington Nursing Home
General Information
UPDATEFederal Provider Number
455835
Provider Name
INTERLOCHEN HEALTH AND REHABILITATION CENTER
Provider Address
2645 W RANDOL MILL RD
ARLINGTON, TX 76012
ARLINGTON, TX 76012
Provider Phone Number
(817) 277-6789
Provider SSA County
910
Provider County Name
Tarrant
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
122
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC ARLINGTON OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1989-08-03
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
1.92933
Reported LPN Staffing Hours per Resident per Day
1.20000
Reported RN Staffing Hours per Resident per Day
0.65200
Reported Licensed Staffing Hours per Resident per Day
1.85200
Reported Total Nurse Staffing Hours per Resident per Day
3.78133
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08000
Expected CNA Staffing Hours per Resident per Day
2.49010
Expected LPN Staffing Hours per Resident per Day
0.78010
Expected RN Staffing Hours per Resident per Day
1.36709
Expected Total Nurse Staffing Hours per Resident per Day
4.63729
Adjusted CNA Staffing Hours per Resident per Day
1.90113
Adjusted LPN Staffing Hours per Resident per Day
1.27676
Adjusted RN Staffing Hours per Resident per Day
0.35636
Adjusted Total Nurse Staffing Hours per Resident per Day
3.28687
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
108
Cycle 1 Standard Survey Health Date
2014-09-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-11-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-10-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
68.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
1625
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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