Chinle Nursing Home - Chinle Nursing Home
General Information
UPDATEFederal Provider Number
35242
Provider Name
CHINLE NURSING HOME
Provider Address
PO BOX 910
CHINLE, AZ 86503
CHINLE, AZ 86503
Provider Phone Number
9286745216
Provider SSA County
0
Provider County Name
Apache
Ownership Type
Non profit - Corporation
Number of Certified Beds
79
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1997-07-10
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
3.79385
Reported LPN Staffing Hours per Resident per Day
0.50000
Reported RN Staffing Hours per Resident per Day
0.51385
Reported Licensed Staffing Hours per Resident per Day
1.01385
Reported Total Nurse Staffing Hours per Resident per Day
4.80770
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.06199
Expected LPN Staffing Hours per Resident per Day
0.55240
Expected RN Staffing Hours per Resident per Day
0.70194
Expected Total Nurse Staffing Hours per Resident per Day
3.31634
Adjusted CNA Staffing Hours per Resident per Day
4.51455
Adjusted LPN Staffing Hours per Resident per Day
0.75127
Adjusted RN Staffing Hours per Resident per Day
0.54698
Adjusted Total Nurse Staffing Hours per Resident per Day
5.84360
Cycle 1 Total Number of Health Deficiencies
30
Cycle 1 Number of Standard Health Deficiencies
30
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
399
Cycle 1 Standard Survey Health Date
2014-11-21
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
200
Cycle 1 Total Health Score
599
Cycle 2 Total Number of Health Deficiencies
26
Cycle 2 Number of Standard Health Deficiencies
26
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
527
Cycle 2 Standard Health Survey Date
2013-09-27
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
264
Cycle 2 Total Health Score
264
Cycle 3 Total Number of Health Deficiencies
23
Cycle 3 Number of Standard Health Deficiencies
23
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
288
Cycle 3 Standard Health Survey Date
2011-09-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
288
Total Weighted Health Survey Score
611.16700
Number of Facility Reported Incidents
11
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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