Lake Lodge Nursing And Rehabilitation Lp - Lake Worth Nursing Home
General Information
UPDATEFederal Provider Number
455903
Provider Name
LAKE LODGE NURSING AND REHABILITATION LP
Provider Address
3800 MARINA DR
LAKE WORTH, TX 76135
LAKE WORTH, TX 76135
Provider Phone Number
(817) 237-7231
Provider SSA County
910
Provider County Name
Tarrant
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
148
Number of Residents in Certified Beds
104
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LAKE LODGE NURSING AND REHABILITATION LP
Date First Approved to Provide Medicare and Medicaid services
1990-11-20
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
1.57067
Reported LPN Staffing Hours per Resident per Day
0.86827
Reported RN Staffing Hours per Resident per Day
0.47452
Reported Licensed Staffing Hours per Resident per Day
1.34279
Reported Total Nurse Staffing Hours per Resident per Day
2.91346
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06058
Expected CNA Staffing Hours per Resident per Day
2.23844
Expected LPN Staffing Hours per Resident per Day
0.66664
Expected RN Staffing Hours per Resident per Day
1.15009
Expected Total Nurse Staffing Hours per Resident per Day
4.05517
Adjusted CNA Staffing Hours per Resident per Day
1.72171
Adjusted LPN Staffing Hours per Resident per Day
1.08104
Adjusted RN Staffing Hours per Resident per Day
0.30829
Adjusted Total Nurse Staffing Hours per Resident per Day
2.89602
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
2014-12-17
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-02-14
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2013-03-09
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
159803
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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