Tomball Rehab & Nursing - Tomball Nursing Home
General Information
UPDATEFederal Provider Number
675714
Provider Name
TOMBALL REHAB & NURSING
Provider Address
815 N PEACH ST
TOMBALL, TX 77375
TOMBALL, TX 77375
Provider Phone Number
(281) 351-5443
Provider SSA County
610
Provider County Name
Harris
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
126
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TOMBALL SNF LLC
Date First Approved to Provide Medicare and Medicaid services
1997-07-09
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
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
2.63529
Reported LPN Staffing Hours per Resident per Day
1.07696
Reported RN Staffing Hours per Resident per Day
0.67500
Reported Licensed Staffing Hours per Resident per Day
1.75196
Reported Total Nurse Staffing Hours per Resident per Day
4.38725
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05735
Expected CNA Staffing Hours per Resident per Day
2.40052
Expected LPN Staffing Hours per Resident per Day
0.68918
Expected RN Staffing Hours per Resident per Day
1.20430
Expected Total Nurse Staffing Hours per Resident per Day
4.29400
Adjusted CNA Staffing Hours per Resident per Day
2.69367
Adjusted LPN Staffing Hours per Resident per Day
1.29702
Adjusted RN Staffing Hours per Resident per Day
0.41880
Adjusted Total Nurse Staffing Hours per Resident per Day
4.11844
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-09-12
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
14
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-08-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
29
Cycle 3 Number of Standard Health Deficiencies
29
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
236
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
236
Total Weighted Health Survey Score
78.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
1853
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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