Magnolia Manor Nursing And Rehab Ctr, Llc - Shreveport Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
195406
Provider Name
MAGNOLIA MANOR NURSING AND REHAB CTR, LLC
Provider Address
1411 CLAIBORNE AVENUE
SHREVEPORT, LA 71103
SHREVEPORT, LA 71103
Provider Phone Number
(318) 868-4421
Provider SSA County
80
Provider County Name
Caddo
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
98
Number of Residents in Certified Beds
83
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MAGNOLIA MANOR NURSING & REHABILITATION CENTER, 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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.31867
Reported LPN Staffing Hours per Resident per Day
0.80422
Reported RN Staffing Hours per Resident per Day
0.42590
Reported Licensed Staffing Hours per Resident per Day
1.23012
Reported Total Nurse Staffing Hours per Resident per Day
3.54879
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06265
Expected CNA Staffing Hours per Resident per Day
2.39448
Expected LPN Staffing Hours per Resident per Day
0.72508
Expected RN Staffing Hours per Resident per Day
1.13557
Expected Total Nurse Staffing Hours per Resident per Day
4.25513
Adjusted CNA Staffing Hours per Resident per Day
2.37601
Adjusted LPN Staffing Hours per Resident per Day
0.92060
Adjusted RN Staffing Hours per Resident per Day
0.28024
Adjusted Total Nurse Staffing Hours per Resident per Day
3.36178
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
20
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
2014-02-14
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
12.66700
Number of Facility Reported Incidents
0
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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