General Information: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Nursing home name COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Address345 COUNTRY CLUB DR
CALDWELL, TX 77836
Phone number (979) 567-4300
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 89
Total number of residents 61
Perc of occupied beds 68
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints3
Number of Fines1
Total Amount of Fines$10800
Total Number of Penalties0
Total Number of Penalties1
Ratings Summary: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Overall rating 2
2
Nursing Home Staffing 1
1
Registered Nurses only 1
1
Health Inspections 2
2
Quality Measures 5
5
Nursing Home Staffing Info: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
National AverageTexas AverageCOPPERAS HOLLOW NURSING & REHABILITATION CENTER
Overall staff rating NA NA 1
1
Registered Nurses only rating NANA 1
1
Total Number of Residents NA NA 61
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 3.79 hours 3.21 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.49 hours 1.05 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.57 hours 0.42 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.92 hours 0.63 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.3 hours 2.15 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.08 hours 0.05 hours
Health Survey: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Heath Survey Summary on 2012-12-13
Total Number of Health Deficiencies 10
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Heath Survey Summary on 2011-11-03
Total Number of Health Deficiencies 5
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2010-08-19
Total Number of Health Deficiencies 7
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Health Survey Details: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Inspection Results: 12/13/2012
Corrected Deficiency Scope and Severity
01/31/2013 Ensure each resident receives an accurate assessment by a qualified health professional. Widespread /Minimal harm or potential for actual harm
01/17/2013 Make sure that special or therapeutic diets are ordered by the attending doctor. Pattern/Minimal harm or potential for actual harm
01/17/2013 Store, cook, and serve food in a safe and clean way. Widespread /Minimal harm or potential for actual harm
01/31/2013 Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Widespread /Minimal harm or potential for actual harm
01/17/2013 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm
01/17/2013 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Widespread /Minimal harm or potential for actual harm
01/31/2013 Give or get quality laboratory services/tests in a timely manner to meet the needs of residents. Pattern/Minimal harm or potential for actual harm
01/31/2013 Provide or obtain laboratory services only when ordered by the attending physician. Isolated/Minimal harm or potential for actual harm
01/17/2013 Quickly tell the resident's doctor the results of laboratory tests. Pattern/Minimal harm or potential for actual harm
01/31/2013 Have a detailed, written plan for disasters and emergencies, such as fire, severe weather, and missing residents. Widespread /Minimal harm or potential for actual harm
Inspection Results: 11/03/2011
Corrected Deficiency Scope and Severity
12/04/2011 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
12/04/2011 Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. Pattern/Minimal harm or potential for actual harm
12/04/2011 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Widespread/Potential for minimal harm
12/04/2011 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm
12/04/2011 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
Inspection Results: 08/19/2010
Corrected Deficiency Scope and Severity
09/19/2010 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
09/19/2010 Conduct initial and periodic assessments of each resident's functional capacity. Pattern/Minimal harm or potential for actual harm
09/19/2010 Provide care by qualified persons according to each resident's written plan of care. Pattern/Minimal harm or potential for actual harm
09/19/2010 Provide necessary care and services to maintain or improve the highest well being of each resident . Pattern/Minimal harm or potential for actual harm
09/19/2010 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
09/19/2010 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm
09/19/2010 Make sure that nurse aides show they have the skills and techniques to be able to care for residents' needs. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Fire Safety Survey Summary on 2012-12-13
Total Number of Fire SafetyDeficiencies 7
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-11-02
Total Number of Fire SafetyDeficiencies 2
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2010-08-19
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Fire Safety Survey Results: 12/13/2012
Corrected Deficiency Severity
01/01/2013 Walls that prevent smoke from passing through and would resist fire for at least one hour. Widespread /Minimal harm or potential for actual harm
01/31/2013 Smoke barrier doors that can resist smoke for at least 20 minutes. Widespread /Minimal harm or potential for actual harm
01/01/2013 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Widespread /Minimal harm or potential for actual harm
01/11/2013 Exits that are accessible at all times. Widespread /Minimal harm or potential for actual harm
01/11/2013 Automatic sprinkler systems that have been maintained in working order. Widespread /Minimal harm or potential for actual harm
12/14/2012 Proper medical gas storage and administration areas. Pattern/Minimal harm or potential for actual harm
12/18/2012 Weekly inspections and monthly testing of generators. Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Results: 11/02/2011
Corrected Deficiency Severity
12/04/2011 Exits that are accessible at all times. Widespread /Minimal harm or potential for actual harm
12/04/2011 An approved automatic sprinkler system connected to the fire alarm system. Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Results: 08/19/2010
Corrected Deficiency Severity
09/19/2010 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Pattern/Minimal harm or potential for actual harm
09/19/2010 Walls that prevent smoke from passing through and would resist fire for at least one hour. Pattern/Minimal harm or potential for actual harm
09/19/2010 An approved automatic sprinkler system connected to the fire alarm system. Pattern/Minimal harm or potential for actual harm
09/19/2010 A complete sprinkler system with alarm system connection. Pattern/Minimal harm or potential for actual harm
09/19/2010 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm

Resident Complaints: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Date Complaint Substantiated: 06/06/2013
CorrectedCategoryDeficiencySeverity
07/02/2013Ensure each resident receives an accurate assessment by a qualified health professional. C
Date Complaint Substantiated: 04/25/2013
CorrectedCategoryDeficiencySeverity
04/25/2013Let residents refuse treatment, refuse to take part in an experiment, or formulate advance directives. K
04/25/2013Keep accurate, complete and organized clinical records on each resident that meet professional standards. K

Quality Measures: COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Quality Measures National Average Texas Average COPPERAS HOLLOW NURSING & REHABILITATION CENTER
Overall quality rating NA NA 5
5
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 19.2% %
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 9.1% 0.8%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.8% 3.0%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 6.0% 1.4%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 43.2% 40.4%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.2% 1.4%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 7.2% 8.5%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 8.1% 2.4%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 1.2% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 3.5% 3.5%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 90.4% 82.4%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 89.7% 66.4%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 27.1% 22.5%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 18.8% 4.5%
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% 73.9%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 73.2% 74.7%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 3.6% 0.0%

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