Senior Village Nursing Home - Perryton Nursing Home
General Information
UPDATEFederal Provider Number
675954
Provider Name
SENIOR VILLAGE NURSING HOME
Provider Address
3101 S. MAIN ST
PERRYTON, TX 79070
PERRYTON, TX 79070
Provider Phone Number
(806) 435-5403
Provider SSA County
831
Provider County Name
Ochiltree
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
60
Number of Residents in Certified Beds
38
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MISSIONARY BAPTIST FOUNDATION OF AMERICA, INC
Date First Approved to Provide Medicare and Medicaid services
2003-02-28
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
3
Overall Rating Footnote
Health Inspection Rating
3
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
2.37632
Reported LPN Staffing Hours per Resident per Day
0.94737
Reported RN Staffing Hours per Resident per Day
0.33158
Reported Licensed Staffing Hours per Resident per Day
1.27895
Reported Total Nurse Staffing Hours per Resident per Day
3.65527
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15000
Expected CNA Staffing Hours per Resident per Day
2.22268
Expected LPN Staffing Hours per Resident per Day
0.55981
Expected RN Staffing Hours per Resident per Day
0.82620
Expected Total Nurse Staffing Hours per Resident per Day
3.60869
Adjusted CNA Staffing Hours per Resident per Day
2.62331
Adjusted LPN Staffing Hours per Resident per Day
1.40461
Adjusted RN Staffing Hours per Resident per Day
0.29987
Adjusted Total Nurse Staffing Hours per Resident per Day
4.08293
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-07-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-06-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-07-19
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
16
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
60.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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