Marine Creek Nursing and Rehabilitation Lp
3600 Angle Ave, Fort Worth, TX 76106


Marine Creek Nursing and Rehabilitation Lp is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 675779. The address is 3600 Angle Ave, Fort Worth, TX 76106. The zip code is 76106. The phone number is 8176246164.


Marine Creek Nursing and Rehabilitation Lp · 3600 Angle Ave, Fort Worth, TX 76106

Federal Provider Number 675779
Provider Name MARINE CREEK NURSING AND REHABILITATION LP
Address 3600 ANGLE AVE
FORT WORTH, TX 76106
Phone Number 8176246164
SSA County Code 910
County Name Tarrant
Ownership Type For profit - Corporation
Certified Beds 170
Certified Beds Residents 125
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name MARINE CREEK NURSING AND REHABILITATION LP
Date First Approved to Provide Medicare Medicaid Services 02/22/1999
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 1
Health Inspection Rating 2
Quality Measure Rating 2
Staffing Rating 1
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 1.8008
Reported LPN Staffing Hours per Resident per Day 0.8572
Reported RN Staffing Hours per Resident per Day 0.2124
Reported Licensed Staffing Hours per Resident per Day 1.0696
Reported Total Nurse Staffing Hours per Resident per Day 2.8704
Reported Physical Therapist Staffing Hours per Resident Per Day 0.0456
Expected CNA Staffing Hours per Resident per Day 2.12953
Expected LPN Staffing Hours per Resident per Day 0.61356
Expected RN Staffing Hours per Resident per Day 1.16984
Expected Total Nurse Staffing Hours per Resident per Day 3.91293
Adjusted CNA Staffing Hours per Resident per Day 2.07493
Adjusted LPN Staffing Hours per Resident per Day 1.15959
Adjusted RN Staffing Hours per Resident per Day 0.13566
Adjusted Total Nurse Staffing Hours per Resident per Day 2.95694
Cycle 1 Total Number of Health Deficiencies 14
Cycle 1 Number of Standard Health Deficiencies 7
Cycle 1 Number of Complaint Health Deficiencies 8
Cycle 1 Health Deficiency Score 148
Cycle 1 Standard Survey Health Date 05/05/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 148
Cycle 2 Total Number of Health Deficiencies 14
Cycle 2 Number of Standard Health Deficiencies 14
Cycle 2 Health Deficiency Score 120
Cycle 2 Standard Health Survey Date 03/18/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 120
Cycle 3 Total Number of Health Deficiencies 4
Cycle 3 Number of Standard Health Deficiencies 4
Cycle 3 Health Deficiency Score 40
Cycle 3 Standard Health Survey Date 04/10/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 40
Total Weighted Health Survey Score 120.667
Number of Facility Reported Incidents 2
Number of Substantiated Complaints 6
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Marine Creek Nursing and Rehabilitation Lp

Owner Name Role Association Date
CUNNINGHAM, SHERRI (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 08/01/2003
DAYBREAK HEALTHCARE, INC. (Organization) PARTNERSHIP INTEREST since 08/01/2003
DAYBREAK PARTNERS LLC (Organization) PARTNERSHIP INTEREST since 08/05/2003
DAYBREAK VENTURE, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
95%
since 08/01/2003
DAYBREAK VENTURE, LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 08/01/2003
DAYBREAK VENTURE, LLC (Organization) PARTNERSHIP INTEREST since 08/01/2003
DBP MANAGEMENT, LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 03/20/2017
ESTATE OF PETER C. KERN (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
20%
since 04/28/2017
FLAGG, DAN (Individual) OFFICER since 03/20/2017
FLAGG, DAN (Individual) OPERATIONAL/MANAGERIAL CONTROL since 03/20/2017
HINCKLEY, JENNIFER (Individual) MANAGING EMPLOYEE since 03/15/2017
MAREZ, DONNA (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 08/01/2003

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