The Broadmoor At Creekside Park - The Woodlands Nursing Home
General Information
UPDATEFederal Provider Number
676357
Provider Name
THE BROADMOOR AT CREEKSIDE PARK
Provider Address
5665 CREEKSIDE FOREST DRIVE
THE WOODLANDS, TX 77389
THE WOODLANDS, TX 77389
Provider Phone Number
(281) 255-8180
Provider SSA County
801
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BROADMOOR CONTINUING CARE CENTER LTD. CO.
Date First Approved to Provide Medicare and Medicaid services
2014-04-10
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.60260
Reported LPN Staffing Hours per Resident per Day
1.59545
Reported RN Staffing Hours per Resident per Day
0.44156
Reported Licensed Staffing Hours per Resident per Day
2.03701
Reported Total Nurse Staffing Hours per Resident per Day
4.63961
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14805
Expected CNA Staffing Hours per Resident per Day
2.44325
Expected LPN Staffing Hours per Resident per Day
0.74230
Expected RN Staffing Hours per Resident per Day
1.40405
Expected Total Nurse Staffing Hours per Resident per Day
4.58960
Adjusted CNA Staffing Hours per Resident per Day
2.61373
Adjusted LPN Staffing Hours per Resident per Day
1.78394
Adjusted RN Staffing Hours per Resident per Day
0.23499
Adjusted Total Nurse Staffing Hours per Resident per Day
4.07483
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
28
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-04-10
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
16.80000
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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