Permian Residential Care Center - Andrews Nursing Home
General Information
UPDATEFederal Provider Number
676175
Provider Name
PERMIAN RESIDENTIAL CARE CENTER
Provider Address
1601 NE MUSTANG
ANDREWS, TX 79714
ANDREWS, TX 79714
Provider Phone Number
(432) 464-2430
Provider SSA County
10
Provider County Name
Andrews
Provider Website
Provider Description
Ownership Type
Government - Hospital district
Number of Certified Beds
90
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
ANDREWS COUNTY HOSPITAL DISTRICT
Date First Approved to Provide Medicare and Medicaid services
2008-05-23
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
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.90870
Reported LPN Staffing Hours per Resident per Day
0.87899
Reported RN Staffing Hours per Resident per Day
0.65942
Reported Licensed Staffing Hours per Resident per Day
1.53841
Reported Total Nurse Staffing Hours per Resident per Day
4.44711
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00290
Expected CNA Staffing Hours per Resident per Day
2.47809
Expected LPN Staffing Hours per Resident per Day
0.59640
Expected RN Staffing Hours per Resident per Day
0.84301
Expected Total Nurse Staffing Hours per Resident per Day
3.91750
Adjusted CNA Staffing Hours per Resident per Day
2.88007
Adjusted LPN Staffing Hours per Resident per Day
1.22328
Adjusted RN Staffing Hours per Resident per Day
0.58447
Adjusted Total Nurse Staffing Hours per Resident per Day
4.57584
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-11-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
623
Cycle 2 Standard Health Survey Date
2013-09-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
623
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
247.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
3
Total Amount of Fines in Dollars
9000
Number of Payment Denials
1
Total Number of Penalties
4
Location
Processing Date
2015-06-01
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