Rock Haven Nursing Home - Nacogdoches Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
676340
Provider Name
ROCK HAVEN NURSING HOME
Provider Address
401 S E STALLINGS DR
NACOGDOCHES, TX 75964
NACOGDOCHES, TX 75964
Provider Phone Number
(936) 569-9411
Provider SSA County
810
Provider County Name
Nacogdoches
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
60
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JEFF D. MILLER, LLC
Date First Approved to Provide Medicare and Medicaid services
2013-08-09
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
1
QM Rating Footnote
Staffing Rating
0
Staffing Rating Footnote
Data Not Available
RN Staffing Rating
0
RN Staffing Rating Footnote
Data Not Available
Reported Staffing Footnote
Staffing Values not Reported because of Data Quality Concerns
Physical Therapist Staffing Footnote
Physical Therapy Staffing Values not Reported because of Data Quality Concerns
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.00000
Reported Licensed Staffing Hours per Resident per Day
0.00000
Reported Total Nurse Staffing Hours per Resident per Day
0.00000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.13507
Expected LPN Staffing Hours per Resident per Day
0.54837
Expected RN Staffing Hours per Resident per Day
0.85389
Expected Total Nurse Staffing Hours per Resident per Day
3.53732
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
220
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
220
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-07-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
173.60000
Number of Facility Reported Incidents
0
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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