Pine Grove Nursing Center - Center Nursing Home

General Information

UPDATE
Federal Provider Number
675230
Provider Name
PINE GROVE NURSING CENTER
Provider Address
246 HALEY DRIVE
CENTER, TX 75935
Provider Phone Number
(936) 598-6286
Provider SSA County
890
Provider County Name
Shelby
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
120
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PINE GROVE SNF LP
Date First Approved to Provide Medicare and Medicaid services
1993-11-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
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
1.41143
Reported LPN Staffing Hours per Resident per Day
1.00214
Reported RN Staffing Hours per Resident per Day
0.50071
Reported Licensed Staffing Hours per Resident per Day
1.50286
Reported Total Nurse Staffing Hours per Resident per Day
2.91428
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08857
Expected CNA Staffing Hours per Resident per Day
2.50471
Expected LPN Staffing Hours per Resident per Day
0.69407
Expected RN Staffing Hours per Resident per Day
1.09771
Expected Total Nurse Staffing Hours per Resident per Day
4.29648
Adjusted CNA Staffing Hours per Resident per Day
1.38269
Adjusted LPN Staffing Hours per Resident per Day
1.19841
Adjusted RN Staffing Hours per Resident per Day
0.34083
Adjusted Total Nurse Staffing Hours per Resident per Day
2.73414
Cycle 1 Total Number of Health Deficiencies
34
Cycle 1 Number of Standard Health Deficiencies
34
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
1084
Cycle 1 Standard Survey Health Date
2014-04-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
1084
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-06-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
491
Cycle 3 Standard Health Survey Date
2012-05-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
491
Total Weighted Health Survey Score
637.16700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
5850
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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