Pine Hill Nursing And Rehabilitation - Jefferson Nursing Home
General Information
UPDATEFederal Provider Number
675241
Provider Name
PINE HILL NURSING AND REHABILITATION
Provider Address
1307 MARTIN LUTHER KING DR
JEFFERSON, TX 75657
JEFFERSON, TX 75657
Provider Phone Number
(903) 665-3951
Provider SSA County
783
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
120
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JEFFERSON I ENTERPRISES, LLC
Date First Approved to Provide Medicare and Medicaid services
1994-01-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.32308
Reported LPN Staffing Hours per Resident per Day
1.24359
Reported RN Staffing Hours per Resident per Day
0.50000
Reported Licensed Staffing Hours per Resident per Day
1.74359
Reported Total Nurse Staffing Hours per Resident per Day
4.06667
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09487
Expected CNA Staffing Hours per Resident per Day
2.28636
Expected LPN Staffing Hours per Resident per Day
0.63725
Expected RN Staffing Hours per Resident per Day
0.99448
Expected Total Nurse Staffing Hours per Resident per Day
3.91810
Adjusted CNA Staffing Hours per Resident per Day
2.49310
Adjusted LPN Staffing Hours per Resident per Day
1.61973
Adjusted RN Staffing Hours per Resident per Day
0.37567
Adjusted Total Nurse Staffing Hours per Resident per Day
4.18375
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
144
Cycle 1 Standard Survey Health Date
2014-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
144
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-01-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-02-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
102.66700
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
1268
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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Magnolia Manor Nursing Home
510 E Bonham |
JEFFERSON TX 75657 | 1 mile away