General Information: PENNSYLVANIA REHAB LP
Nursing home name PENNSYLVANIA REHAB LP
Address901 PENNSYLVANIA AVE
FORT WORTH, TX 76104
Phone number (817) 335-3030
Located within a hospital No
Type of ownership For profit - Individual
Owner operates multiple homesNo
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 123
Total number of residents 87
Perc of occupied beds 70
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints2
Number of Fines1
Total Amount of Fines$1625
Total Number of Penalties0
Total Number of Penalties1
Ratings Summary: PENNSYLVANIA REHAB LP
Overall rating 4
4
Nursing Home Staffing 4
4
Registered Nurses only 2
2
Health Inspections 4
4
Quality Measures 4
4
Nursing Home Staffing Info: PENNSYLVANIA REHAB LP
National AverageTexas AveragePENNSYLVANIA REHAB LP
Overall staff rating NA NA 4
4
Registered Nurses only rating NANA 2
2
Total Number of Residents NA NA 87
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 3.79 hours 4.23 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.49 hours 1.11 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.57 hours 0.37 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.92 hours 0.74 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.3 hours 3.12 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.08 hours 0.1 hours
Health Survey: PENNSYLVANIA REHAB LP
Heath Survey Summary on 2013-10-31
Total Number of Health Deficiencies 2
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2012-10-05
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Heath Survey Summary on 2011-10-06
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Isolated/Actual harm
Health Survey Details: PENNSYLVANIA REHAB LP
Inspection Results: 10/31/2013
Corrected Deficiency Scope and Severity
12/12/2013 Keep each resident free from physical restraints, unless needed for medical treatment. Pattern/Minimal harm or potential for actual harm
12/13/2013 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Pattern/Minimal harm or potential for actual harm
Inspection Results: 10/05/2012
Corrected Deficiency Scope and Severity
11/05/2012 Make sure that nurse aides show they have the skills and techniques to be able to care for residents' needs. Pattern/Minimal harm or potential for actual harm
11/05/2012 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm
11/05/2012 1) Review the work of each nurse aide every year; and 2) give regular in-service training based upon these reviews. Widespread /Minimal harm or potential for actual harm
Inspection Results: 10/06/2011
Corrected Deficiency Scope and Severity
11/07/2011 Make sure that each residents' abilities in activities of daily living do not decline, unless unavoidable. Isolated/Actual harm
11/07/2011 Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Pattern/Minimal harm or potential for actual harm
11/07/2011 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm

Fire Safety Survey: PENNSYLVANIA REHAB LP
Fire Safety Survey Summary on 2013-10-30
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-10-03
Total Number of Fire SafetyDeficiencies 8
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-10-05
Total Number of Fire SafetyDeficiencies 4
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey: PENNSYLVANIA REHAB LP
Fire Safety Survey Results: 10/30/2013
Corrected Deficiency Severity
12/10/2013 Smoke barrier doors that can resist smoke for at least 20 minutes. Widespread /Minimal harm or potential for actual harm
12/12/2013 Exits that are accessible at all times. Widespread /Minimal harm or potential for actual harm
12/10/2013 Portable fire extinguishers. Pattern/Potential for minimal harm
12/12/2013 Posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Widespread /Minimal harm or potential for actual harm
12/12/2013 Properly sized and located linen or trash receptacles. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 10/03/2012
Corrected Deficiency Severity
11/13/2012 Posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Widespread /Minimal harm or potential for actual harm
11/05/2012 Exits that are free from obstructions and can be used at all times. Pattern/Minimal harm or potential for actual harm
11/05/2012 Restrictions on the use of portable space heaters. Pattern/Minimal harm or potential for actual harm
11/13/2012 Weekly inspections and monthly testing of generators. Widespread /Minimal harm or potential for actual harm
11/13/2012 Record of quarterly fire drills for each shift under varying conditions. Widespread/Potential for minimal harm
11/13/2012 Smoke barrier doors that can resist smoke for at least 20 minutes. Widespread /Minimal harm or potential for actual harm
11/05/2012 Properly installed electrical wiring and equipment. Widespread /Minimal harm or potential for actual harm
11/13/2012 Corridor and hallway doors that block smoke. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 10/05/2011
Corrected Deficiency Severity
10/07/2011 An approved installation, maintenance and testing program for fire alarm systems. Pattern/Potential for minimal harm
10/07/2011 Portable fire extinguishers. Widespread/Potential for minimal harm
11/07/2011 Posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Widespread /Minimal harm or potential for actual harm
11/07/2011 Properly protected cooking facilities. Widespread/Potential for minimal harm

Resident Complaints: PENNSYLVANIA REHAB LP
Date Complaint Substantiated: 10/08/2013
CorrectedCategoryDeficiencySeverity
11/05/2013Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. E
Date Complaint Substantiated: 03/08/2012
CorrectedCategoryDeficiencySeverity
Have a program that investigates, controls and keeps infection from spreading. E
Date Complaint Substantiated: 09/20/2011
CorrectedCategoryDeficiencySeverity
10/14/2011Have a program that investigates, controls and keeps infection from spreading. E

Quality Measures: PENNSYLVANIA REHAB LP
Quality Measures National Average Texas Average PENNSYLVANIA REHAB LP
Overall quality rating NA NA 4
4
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 19.2% 18.6%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 9.1% 24.0%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.8% 12.1%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 6.0% 9.7%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 43.2% 8.7%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.2% 1.1%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 7.2% 7.6%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 8.1% 10.2%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 1.2% 0.4%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 3.5% 0.4%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 90.4% 100.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 89.7% 84.2%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 27.1% 67.6%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 18.8% 22.9%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.2% 0.0%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 74.3% 100.0%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 73.2% 86.7%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 3.6% %

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