Life Care Center Of Haltom - Fort Worth Nursing Home
General Information
UPDATEFederal Provider Number
675935
Provider Name
LIFE CARE CENTER OF HALTOM
Provider Address
2936 MARKUM DR
FORT WORTH, TX 76117
FORT WORTH, TX 76117
Provider Phone Number
(817) 831-0545
Provider SSA County
910
Provider County Name
Tarrant
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
127
Number of Residents in Certified Beds
105
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HALTOM OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
2002-08-05
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.86619
Reported LPN Staffing Hours per Resident per Day
0.83095
Reported RN Staffing Hours per Resident per Day
0.66476
Reported Licensed Staffing Hours per Resident per Day
1.49571
Reported Total Nurse Staffing Hours per Resident per Day
3.36190
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12810
Expected CNA Staffing Hours per Resident per Day
2.45481
Expected LPN Staffing Hours per Resident per Day
0.62160
Expected RN Staffing Hours per Resident per Day
1.13173
Expected Total Nurse Staffing Hours per Resident per Day
4.20815
Adjusted CNA Staffing Hours per Resident per Day
1.86535
Adjusted LPN Staffing Hours per Resident per Day
1.10953
Adjusted RN Staffing Hours per Resident per Day
0.43889
Adjusted Total Nurse Staffing Hours per Resident per Day
3.22029
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-08
Cycle 2 Number of Health Revisits
0
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
2013-06-21
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
12.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
2
Total Amount of Fines in Dollars
3750
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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