Jacksboro Healthcare Center - Jacksboro Nursing Home
General Information
UPDATEFederal Provider Number
455808
Provider Name
JACKSBORO HEALTHCARE CENTER
Provider Address
211 E JASPER ST
JACKSBORO, TX 76458
JACKSBORO, TX 76458
Provider Phone Number
(940) 567-2686
Provider SSA County
680
Provider County Name
Jack
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
33
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1989-04-20
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.93788
Reported LPN Staffing Hours per Resident per Day
0.58485
Reported RN Staffing Hours per Resident per Day
0.25909
Reported Licensed Staffing Hours per Resident per Day
0.84394
Reported Total Nurse Staffing Hours per Resident per Day
1.78182
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01515
Expected CNA Staffing Hours per Resident per Day
2.33092
Expected LPN Staffing Hours per Resident per Day
0.65109
Expected RN Staffing Hours per Resident per Day
0.96468
Expected Total Nurse Staffing Hours per Resident per Day
3.94669
Adjusted CNA Staffing Hours per Resident per Day
0.98728
Adjusted LPN Staffing Hours per Resident per Day
0.74556
Adjusted RN Staffing Hours per Resident per Day
0.20068
Adjusted Total Nurse Staffing Hours per Resident per Day
1.81984
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-05-30
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-06-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
66.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
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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