Pine Arbor - Silsbee Nursing Home
General Information
UPDATEFederal Provider Number
675391
Provider Name
PINE ARBOR
Provider Address
705 HWY 418 W
SILSBEE, TX 77656
SILSBEE, TX 77656
Provider Phone Number
(409) 385-0033
Provider SSA County
600
Provider County Name
Hardin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC SILSBEE OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1994-09-21
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
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
1.61000
Reported LPN Staffing Hours per Resident per Day
1.18364
Reported RN Staffing Hours per Resident per Day
0.48909
Reported Licensed Staffing Hours per Resident per Day
1.67273
Reported Total Nurse Staffing Hours per Resident per Day
3.28273
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09091
Expected CNA Staffing Hours per Resident per Day
2.43698
Expected LPN Staffing Hours per Resident per Day
0.70206
Expected RN Staffing Hours per Resident per Day
1.20419
Expected Total Nurse Staffing Hours per Resident per Day
4.34322
Adjusted CNA Staffing Hours per Resident per Day
1.62105
Adjusted LPN Staffing Hours per Resident per Day
1.39935
Adjusted RN Staffing Hours per Resident per Day
0.30348
Adjusted Total Nurse Staffing Hours per Resident per Day
3.04667
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2014-09-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
485
Cycle 2 Standard Health Survey Date
2013-10-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
485
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-11-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
204.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
Number of Fines
2
Total Amount of Fines in Dollars
7544
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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