Park Valley Inn Health Center - Round Rock Nursing Home
General Information
UPDATEFederal Provider Number
676202
Provider Name
PARK VALLEY INN HEALTH CENTER
Provider Address
17751 PARK VALLEY DR
ROUND ROCK, TX 78681
ROUND ROCK, TX 78681
Provider Phone Number
5122186000
Provider SSA County
970
Provider County Name
Williamson
Ownership Type
For profit - Individual
Number of Certified Beds
128
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PM MANAGEMENT - PARK VALLEY NC LLC
Date First Approved to Provide Medicare and Medicaid services
2008-11-07
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
2
Health Inspection Rating Footnote
QM Rating
2
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
2.49211
Reported LPN Staffing Hours per Resident per Day
0.99737
Reported RN Staffing Hours per Resident per Day
0.59158
Reported Licensed Staffing Hours per Resident per Day
1.58895
Reported Total Nurse Staffing Hours per Resident per Day
4.08106
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11632
Expected CNA Staffing Hours per Resident per Day
2.54313
Expected LPN Staffing Hours per Resident per Day
0.75733
Expected RN Staffing Hours per Resident per Day
1.33176
Expected Total Nurse Staffing Hours per Resident per Day
4.63222
Adjusted CNA Staffing Hours per Resident per Day
2.40447
Adjusted LPN Staffing Hours per Resident per Day
1.09307
Adjusted RN Staffing Hours per Resident per Day
0.33191
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55128
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
20
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
240
Cycle 2 Standard Health Survey Date
2014-04-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-05-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
120.00000
Number of Facility Reported Incidents
2
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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