Stamford Residence And Rehabilitation Center - Stamford Nursing Home
General Information
UPDATEFederal Provider Number
675769
Provider Name
STAMFORD RESIDENCE AND REHABILITATION CENTER
Provider Address
1003 COLUMBIA
STAMFORD, TX 79553
STAMFORD, TX 79553
Provider Phone Number
(325) 773-3671
Provider SSA County
721
Provider County Name
Jones
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
118
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMBASSADOR MEDICAL SUPPLY OF TEXAS INC.
Date First Approved to Provide Medicare and Medicaid services
1998-10-19
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.59651
Reported LPN Staffing Hours per Resident per Day
1.00000
Reported RN Staffing Hours per Resident per Day
0.50465
Reported Licensed Staffing Hours per Resident per Day
1.50465
Reported Total Nurse Staffing Hours per Resident per Day
3.10116
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.29953
Expected LPN Staffing Hours per Resident per Day
0.56599
Expected RN Staffing Hours per Resident per Day
0.88332
Expected Total Nurse Staffing Hours per Resident per Day
3.74884
Adjusted CNA Staffing Hours per Resident per Day
1.70355
Adjusted LPN Staffing Hours per Resident per Day
1.46645
Adjusted RN Staffing Hours per Resident per Day
0.42688
Adjusted Total Nurse Staffing Hours per Resident per Day
3.33449
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-05-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2013-05-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
100
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
100
Total Weighted Health Survey Score
79.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
11
Number of Fines
1
Total Amount of Fines in Dollars
1138
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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