Mira Vista Court - Fort Worth Nursing Home
General Information
UPDATEFederal Provider Number
676067
Provider Name
MIRA VISTA COURT
Provider Address
7021 BRYANT IRVIN RD
FORT WORTH, TX 76132
FORT WORTH, TX 76132
Provider Phone Number
(817) 361-1400
Provider SSA County
910
Provider County Name
Tarrant
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
86
Number of Residents in Certified Beds
86
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
2005-10-04
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
4
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
1.95465
Reported LPN Staffing Hours per Resident per Day
0.78081
Reported RN Staffing Hours per Resident per Day
0.57267
Reported Licensed Staffing Hours per Resident per Day
1.35349
Reported Total Nurse Staffing Hours per Resident per Day
3.30813
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02093
Expected CNA Staffing Hours per Resident per Day
2.37773
Expected LPN Staffing Hours per Resident per Day
0.70927
Expected RN Staffing Hours per Resident per Day
1.31008
Expected Total Nurse Staffing Hours per Resident per Day
4.39709
Adjusted CNA Staffing Hours per Resident per Day
2.01710
Adjusted LPN Staffing Hours per Resident per Day
0.91371
Adjusted RN Staffing Hours per Resident per Day
0.32662
Adjusted Total Nurse Staffing Hours per Resident per Day
3.03263
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-02-13
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-02-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-12-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
5
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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