Manda Ann Convalescent Home Inc - Houston Nursing Home
General Information
UPDATEFederal Provider Number
45F213
Provider Name
MANDA ANN CONVALESCENT HOME INC
Provider Address
7441 COFFEE ST
HOUSTON, TX 77033
HOUSTON, TX 77033
Provider Phone Number
(713) 733-9471
Provider SSA County
610
Provider County Name
Harris
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
91
Number of Residents in Certified Beds
68
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1988-07-29
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
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
2.36985
Reported LPN Staffing Hours per Resident per Day
0.76544
Reported RN Staffing Hours per Resident per Day
0.30074
Reported Licensed Staffing Hours per Resident per Day
1.06618
Reported Total Nurse Staffing Hours per Resident per Day
3.43603
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01250
Expected CNA Staffing Hours per Resident per Day
2.18698
Expected LPN Staffing Hours per Resident per Day
0.61805
Expected RN Staffing Hours per Resident per Day
0.84897
Expected Total Nurse Staffing Hours per Resident per Day
3.65400
Adjusted CNA Staffing Hours per Resident per Day
2.65887
Adjusted LPN Staffing Hours per Resident per Day
1.02793
Adjusted RN Staffing Hours per Resident per Day
0.26469
Adjusted Total Nurse Staffing Hours per Resident per Day
3.79045
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
156
Cycle 1 Standard Survey Health Date
2014-06-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
156
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-05-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2012-05-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
120
Total Weighted Health Survey Score
119.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
11
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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