Provider Name: SHREVEPORT MANOR SKILLED NURSING & REHABILITATION
Address: 3302 MANSFIELD ROAD, SHREVEPORT, LA 71103
Phone: (318) 222-9482
County: Caddo (080)
Ownership Type: For profit - Limited Liability company
Certified Beds: 127
Average Residents Per Day: 56.7 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: PMG OPCO-SHREVEPORT LLC
First Approved Date: January 30, 2001
Affiliated Entity: PRIORITY MANAGEMENT (425)
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 4 ()
Health Inspection Rating: 4 ()
QM Rating: 5 ()
Long Stay QM Rating: 5 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 1 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 1.91923, LPN Staff Hours Per Day: 1.2111, RN Staff Hours Per Day: 0.1625, Licensed Staff Hours Per Day: 1.3736
Total Nurse Staff Hours Per Day, per resident: 3.29291
Weekend Nurse Staff Hours: 2.92585, Weekend RN Staff Hours: 0.1558
PT Staff Hours Per Day, per resident: 0.0816
Nurse Staff Turnover: 43.9, Nurse Turnover Note:
RN Turnover: , RN Turnover Note: 6
Admin Left Number: 2, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.2168, Case Mix LPN Hours Per Day: 0.8907, Case Mix RN Hours Per Day: 0.5542
Adjusted Nurse Aide Hours Per Day, per resident: 1.76374, Adjusted LPN Hours Per Day: 1.0034, Adjusted RN Hours Per Day: 0.1104
Total Adjusted Nurse Hours Per Day, per resident: 2.83448
Adjusted Weekend Nurse Hours Per Day, per resident: 2.51853
Health Survey Dates and Scores: Cycle 1: 2023-08-30 (Score: 0), Cycle 2: 2022-08-17 (Score: 20), Cycle 3: 2021-09-29 (Score: 24)
Total Weighted Health Score: 10.667
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations: 0
Fines and Penalties: Number of Fines: 4, Total Fines in Dollars: 22802.67, Payment Denials Number: 0, Total Penalties Number: 4
Location and GPS: 3302 MANSFIELD ROAD,SHREVEPORT,LA,71103 (32.4800, -93.773)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-09-26
Type: Health, Deficiency: Provide care and assistance to perform activities of daily living for any resident who is unable.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-09-26
Type: Health, Deficiency: Provide safe and appropriate respiratory care for a resident when needed.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-09-26
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-09-26
Type: Health, Deficiency: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-11-12
Type: Health, Deficiency: Provide care and assistance to perform activities of daily living for any resident who is unable.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-11-12
Type: Health, Deficiency: Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-11-12
Type: Health, Deficiency: Provide enough food/fluids to maintain a resident's health.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-11-12
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0211, Version: New
Description: Keep aisles, corridors, and exits free of obstruction in case of emergency.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has no plan of correction on
Type: Fire Safety, Tag: 0363, Version: New
Description: Install corridor and hallway doors that block smoke.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-09-22
Type: Fire Safety, Tag: 0521, Version: New
Description: Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has no plan of correction on
Type: Fire Safety, Tag: 0353, Version: New
Description: Inspect, test, and maintain automatic sprinkler systems.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-10-04