Southbrooke Manor Nursing And Rehabilitation Cente - Edna Nursing Home
General Information
UPDATEFederal Provider Number
675159
Provider Name
SOUTHBROOKE MANOR NURSING AND REHABILITATION CENTE
Provider Address
1401 W MAIN ST
EDNA, TX 77957
EDNA, TX 77957
Provider Phone Number
(361) 782-7614
Provider SSA County
681
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
120
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CITIZENS MEDICAL CENTER COUNTY OF VICTORIA
Date First Approved to Provide Medicare and Medicaid services
1993-07-01
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
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
2
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
1.80309
Reported LPN Staffing Hours per Resident per Day
0.75412
Reported RN Staffing Hours per Resident per Day
0.40412
Reported Licensed Staffing Hours per Resident per Day
1.15825
Reported Total Nurse Staffing Hours per Resident per Day
2.96133
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02010
Expected CNA Staffing Hours per Resident per Day
2.26715
Expected LPN Staffing Hours per Resident per Day
0.68229
Expected RN Staffing Hours per Resident per Day
1.20727
Expected Total Nurse Staffing Hours per Resident per Day
4.15671
Adjusted CNA Staffing Hours per Resident per Day
1.95146
Adjusted LPN Staffing Hours per Resident per Day
0.91737
Adjusted RN Staffing Hours per Resident per Day
0.25012
Adjusted Total Nurse Staffing Hours per Resident per Day
2.87170
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-04-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-04-05
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-02-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
14.00000
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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