Braswell's Hampton Manor - Yucaipa Nursing Home
General Information
UPDATEFederal Provider Number
555494
Provider Name
BRASWELL'S HAMPTON MANOR
Provider Address
11970 4TH STREET
YUCAIPA, CA 92399
YUCAIPA, CA 92399
Provider Phone Number
9097902273
Provider SSA County
460
Provider County Name
San Bernardino
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
89
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BRASWELLS HAMPTON MANOR LP
Date First Approved to Provide Medicare and Medicaid services
1992-01-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.27921
Reported LPN Staffing Hours per Resident per Day
0.86742
Reported RN Staffing Hours per Resident per Day
0.81348
Reported Licensed Staffing Hours per Resident per Day
1.68090
Reported Total Nurse Staffing Hours per Resident per Day
3.96011
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05281
Expected CNA Staffing Hours per Resident per Day
2.44573
Expected LPN Staffing Hours per Resident per Day
0.63885
Expected RN Staffing Hours per Resident per Day
1.06893
Expected Total Nurse Staffing Hours per Resident per Day
4.15351
Adjusted CNA Staffing Hours per Resident per Day
2.28664
Adjusted LPN Staffing Hours per Resident per Day
1.12696
Adjusted RN Staffing Hours per Resident per Day
0.56863
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84321
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-02-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-03-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-04-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
29.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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