San Jacinto Manor - Deer Park Nursing Home
General Information
UPDATEFederal Provider Number
675392
Provider Name
SAN JACINTO MANOR
Provider Address
206 W P ST
DEER PARK, TX 77536
DEER PARK, TX 77536
Provider Phone Number
2814798471
Provider SSA County
610
Provider County Name
Harris
Ownership Type
For profit - Partnership
Number of Certified Beds
96
Number of Residents in Certified Beds
85
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PINNACLE HEALTH FACILITIES XXX LP
Date First Approved to Provide Medicare and Medicaid services
1994-10-03
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
3
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
1.71765
Reported LPN Staffing Hours per Resident per Day
0.80412
Reported RN Staffing Hours per Resident per Day
0.39176
Reported Licensed Staffing Hours per Resident per Day
1.19588
Reported Total Nurse Staffing Hours per Resident per Day
2.91353
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11706
Expected CNA Staffing Hours per Resident per Day
2.57346
Expected LPN Staffing Hours per Resident per Day
0.63800
Expected RN Staffing Hours per Resident per Day
1.00326
Expected Total Nurse Staffing Hours per Resident per Day
4.21471
Adjusted CNA Staffing Hours per Resident per Day
1.63772
Adjusted LPN Staffing Hours per Resident per Day
1.04611
Adjusted RN Staffing Hours per Resident per Day
0.29177
Adjusted Total Nurse Staffing Hours per Resident per Day
2.78646
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-10-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
50.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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