Park Manor Of Humble - Humble Nursing Home
General Information
UPDATEFederal Provider Number
675991
Provider Name
PARK MANOR OF HUMBLE
Provider Address
19424 MCKAY DR
HUMBLE, TX 77338
HUMBLE, TX 77338
Provider Phone Number
(281) 319-4060
Provider SSA County
610
Provider County Name
Harris
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
125
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HMG PARK MANOR OF HUMBLE, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
2003-10-23
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
2.44020
Reported LPN Staffing Hours per Resident per Day
1.02402
Reported RN Staffing Hours per Resident per Day
0.66863
Reported Licensed Staffing Hours per Resident per Day
1.69265
Reported Total Nurse Staffing Hours per Resident per Day
4.13285
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05588
Expected CNA Staffing Hours per Resident per Day
2.55249
Expected LPN Staffing Hours per Resident per Day
0.79110
Expected RN Staffing Hours per Resident per Day
1.53032
Expected Total Nurse Staffing Hours per Resident per Day
4.87392
Adjusted CNA Staffing Hours per Resident per Day
2.34575
Adjusted LPN Staffing Hours per Resident per Day
1.07437
Adjusted RN Staffing Hours per Resident per Day
0.32647
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41801
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
112
Cycle 1 Standard Survey Health Date
2014-10-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
112
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-08-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
100.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
10
Number of Fines
1
Total Amount of Fines in Dollars
22360
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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