Retama Manor Nursing Center/victoria South - Victoria Nursing Home
General Information
UPDATEFederal Provider Number
455726
Provider Name
RETAMA MANOR NURSING CENTER/VICTORIA SOUTH
Provider Address
3103 E AIRLINE DR
VICTORIA, TX 77901
VICTORIA, TX 77901
Provider Phone Number
(361) 575-6457
Provider SSA County
948
Provider County Name
Victoria
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
142
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FMSC VICTORIA OPERATING COMPANY LP
Date First Approved to Provide Medicare and Medicaid services
1987-11-30
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
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.73859
Reported LPN Staffing Hours per Resident per Day
1.03533
Reported RN Staffing Hours per Resident per Day
0.43424
Reported Licensed Staffing Hours per Resident per Day
1.46957
Reported Total Nurse Staffing Hours per Resident per Day
3.20816
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09185
Expected CNA Staffing Hours per Resident per Day
2.36555
Expected LPN Staffing Hours per Resident per Day
0.68079
Expected RN Staffing Hours per Resident per Day
1.33802
Expected Total Nurse Staffing Hours per Resident per Day
4.38436
Adjusted CNA Staffing Hours per Resident per Day
1.80337
Adjusted LPN Staffing Hours per Resident per Day
1.26224
Adjusted RN Staffing Hours per Resident per Day
0.24250
Adjusted Total Nurse Staffing Hours per Resident per Day
2.94952
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
128
Cycle 1 Standard Survey Health Date
2014-04-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
128
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
24
Cycle 2 Standard Health Survey Date
2013-03-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
79.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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