Sandy Lake Rehabilitation And Care Center - Coppell Nursing Home
General Information
UPDATEFederal Provider Number
676247
Provider Name
SANDY LAKE REHABILITATION AND CARE CENTER
Provider Address
1410 E SANDY LAKE RD
COPPELL, TX 75019
COPPELL, TX 75019
Provider Phone Number
(972) 304-4444
Provider SSA County
390
Provider County Name
Dallas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
123
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARE INN OF SANGER LLC
Date First Approved to Provide Medicare and Medicaid services
2010-03-10
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
2.13571
Reported LPN Staffing Hours per Resident per Day
1.02381
Reported RN Staffing Hours per Resident per Day
0.52917
Reported Licensed Staffing Hours per Resident per Day
1.55298
Reported Total Nurse Staffing Hours per Resident per Day
3.68869
Reported Physical Therapist Staffing Hours per Resident Per Day
0.26429
Expected CNA Staffing Hours per Resident per Day
2.48869
Expected LPN Staffing Hours per Resident per Day
0.75482
Expected RN Staffing Hours per Resident per Day
1.35768
Expected Total Nurse Staffing Hours per Resident per Day
4.60120
Adjusted CNA Staffing Hours per Resident per Day
2.10568
Adjusted LPN Staffing Hours per Resident per Day
1.12578
Adjusted RN Staffing Hours per Resident per Day
0.29123
Adjusted Total Nurse Staffing Hours per Resident per Day
3.23149
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-01-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-01-04
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
18.66700
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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