Park Manor Of Tomball - Tomball Nursing Home
General Information
UPDATEFederal Provider Number
676165
Provider Name
PARK MANOR OF TOMBALL
Provider Address
250 SCHOOL STREET
TOMBALL, TX 77375
TOMBALL, TX 77375
Provider Phone Number
(281) 516-7929
Provider SSA County
610
Provider County Name
Harris
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
125
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HMG PARK MANOR OF TOMBALL, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
2008-01-24
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.35567
Reported LPN Staffing Hours per Resident per Day
0.99691
Reported RN Staffing Hours per Resident per Day
0.39485
Reported Licensed Staffing Hours per Resident per Day
1.39175
Reported Total Nurse Staffing Hours per Resident per Day
3.74743
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06907
Expected CNA Staffing Hours per Resident per Day
2.51164
Expected LPN Staffing Hours per Resident per Day
0.81804
Expected RN Staffing Hours per Resident per Day
1.39853
Expected Total Nurse Staffing Hours per Resident per Day
4.72821
Adjusted CNA Staffing Hours per Resident per Day
2.30133
Adjusted LPN Staffing Hours per Resident per Day
1.01149
Adjusted RN Staffing Hours per Resident per Day
0.21096
Adjusted Total Nurse Staffing Hours per Resident per Day
3.19476
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-11-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-10-31
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
9
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-11-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
46.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
9
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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