WESTERN HILLS NURSING & REHABILITATION Nursing Home


WESTERN HILLS NURSING & REHABILITATION (CCN: 455785) is a Government - Hospital district facility located in TEMPLE, TX (76504). The facility has an overall rating of 1/5, health inspection rating of 2/5, and a staffing rating of 1/5. It offers 120 certified beds and maintains an average of 83.9 residents per day. The nursing staff includes Nurse Aides, LPNs, and RNs working 2.38195 total hours per resident per day. It has been certified since December 2, 1988 and the last listed health inspection was on February 8, 2023, The facility is located in Bell county and provides senior and nursing home care.

WESTERN HILLS NURSING & REHABILITATION Summary


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Provider Name: WESTERN HILLS NURSING & REHABILITATION

Address: 512 DRAPER DR, TEMPLE, TX 76504

Phone: (254) 742-7500

County: Bell (120)

Ownership Type: Government - Hospital district

Certified Beds: 120

Average Residents Per Day: 83.9 ()

Provider Type: Medicare and Medicaid, Resides in Hospital: No

Legal Business Name: STRATFORD HOSPITAL DISTRICT

First Approved Date: December 2, 1988

Affiliated Entity: CARADAY HEALTHCARE (103)

Retirement Community: N, Special Focus Status:

Ownership Change in Last 12 Months: N

Resident Family Council: Resident

Sprinkler System Status: Yes

Overall Rating: 1 ()

Health Inspection Rating: 2 ()

QM Rating: 4 ()

Long Stay QM Rating: 5 ()

Short Stay QM Rating: 3 ()

Staffing Rating: 1 ()

Staffing Report Note:

PT Staffing Note:

Nurse Aide Staff Hours Per Day, per resident: 1.34573, LPN Staff Hours Per Day: 0.8344, RN Staff Hours Per Day: 0.2017, Licensed Staff Hours Per Day: 1.0362

Total Nurse Staff Hours Per Day, per resident: 2.38195

Weekend Nurse Staff Hours: 2.20203, Weekend RN Staff Hours: 0.1143

PT Staff Hours Per Day, per resident: 0.0429

Nurse Staff Turnover: 76.6, Nurse Turnover Note:

RN Turnover: 60.0, RN Turnover Note:

Admin Left Number: 0, Admin Turnover Note:

Case Mix Nurse Aide Hours Per Day, per resident: 1.9698, Case Mix LPN Hours Per Day: 0.8107, Case Mix RN Hours Per Day: 0.4390

Adjusted Nurse Aide Hours Per Day, per resident: 1.39176, Adjusted LPN Hours Per Day: 0.7595, Adjusted RN Hours Per Day: 0.1731

Total Adjusted Nurse Hours Per Day, per resident: 2.33193

Adjusted Weekend Nurse Hours Per Day, per resident: 2.15579

Health Survey Dates and Scores: Cycle 1: 2023-02-08 (Score: 119), Cycle 2: 2021-11-05 (Score: 24), Cycle 3: 2020-01-08 (Score: 4)

Total Weighted Health Score: 68.167

Reported Incidents: 0, Substantiated Complaints: 1

Infection Control Citations: 0

Fines and Penalties: Number of Fines: 2, Total Fines in Dollars: 13000.00, Payment Denials Number: 0, Total Penalties Number: 2

Location and GPS: 512 DRAPER DR,TEMPLE,TX,76504 (31.1094, -97.369)

Process Date: 2024-03-01


Health Inspection Citations Details

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:

Citation on 2023-06-20

Type: Health, Deficiency: Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Severity: H - Level 3: Actual harm that is not immediate jeopardy. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2023-07-14

Citation on 2023-06-20

Type: Health, Deficiency: Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Severity: H - Level 3: Actual harm that is not immediate jeopardy. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2023-07-14

Citation on 2023-02-08

Type: Health, Deficiency: Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2023-03-03

Citation on 2023-02-08

Type: Health, Deficiency: Keep residents' personal and medical records private and confidential.

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 2023-03-10

Citation on 2023-02-08

Type: Health, Deficiency: Provide safe and appropriate respiratory care for a resident when needed.

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 2023-03-10

Citation on 2023-02-08

Type: Health, Deficiency: Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

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 2023-03-10

Citation on 2023-02-08

Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

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 2023-03-10

Citation on 2023-02-08

Type: Health, Deficiency: Provide and implement an infection prevention and control program.

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 2023-03-10

Citation on 2022-07-18

Type: Health, Deficiency: Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

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 2022-08-08

Citation on 2021-11-05

Type: Health, Deficiency: Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

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 2021-12-08

Citation on 2021-11-05

Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

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 2021-12-08

Citation on 2021-11-05

Type: Health, Deficiency: Provide and implement an infection prevention and control program.

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 2021-12-08

Citation on 2020-01-08

Type: Health, Deficiency: Provide and implement an infection prevention and control program.

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 2020-01-15


Fire Safety Citations Details

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:

Citation on 2023-06-14

Type: Fire Safety, Tag: 0222, Version: New

Description: Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

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 2023-06-15

Citation on 2023-06-14

Type: Fire Safety, Tag: 0345, Version: New

Description: Have approved installation, maintenance and testing program for fire alarm systems.

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 2023-06-15

Citation on 2023-06-14

Type: Fire Safety, Tag: 0353, Version: New

Description: Inspect, test, and maintain automatic sprinkler systems.

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 2023-06-27

Citation on 2023-06-14

Type: Fire Safety, Tag: 0374, Version: New

Description: Install smoke barrier doors that can resist smoke for at least 20 minutes.

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 2023-06-15

Citation on 2023-06-14

Type: Fire Safety, Tag: 0900, Version: New

Description: Meet Health Care Facilities Code mechanical requirements.

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 2023-06-15

Citation on 2023-06-14

Type: Fire Safety, Tag: 0918, Version: New

Description: Have generator or other power source capable of supplying service within 10 seconds.

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 2023-06-15

Citation on 2023-06-14

Type: Fire Safety, Tag: 0929, Version: New

Description: Ensure precautions for handling oxygen cylinders and equipment are correctly followed.

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 2023-07-14

Citation on 2020-01-07

Type: Fire Safety, Tag: 0741, Version: New

Description: Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

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 2020-01-15