Haven Home - Kenesaw Nursing Home
General Information
UPDATEFederal Provider Number
285166
Provider Name
HAVEN HOME
Provider Address
P O BOX 10, 100 WEST ELM AVENUE
KENESAW, NE 68956
KENESAW, NE 68956
Provider Phone Number
4027523212
Provider SSA County
0
Provider County Name
Adams
Ownership Type
For profit - Corporation
Number of Certified Beds
76
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC KENESAW OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1995-10-17
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
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
1.20104
Reported LPN Staffing Hours per Resident per Day
0.81146
Reported RN Staffing Hours per Resident per Day
0.66458
Reported Licensed Staffing Hours per Resident per Day
1.47604
Reported Total Nurse Staffing Hours per Resident per Day
2.67708
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10313
Expected CNA Staffing Hours per Resident per Day
2.35038
Expected LPN Staffing Hours per Resident per Day
0.58499
Expected RN Staffing Hours per Resident per Day
0.87928
Expected Total Nurse Staffing Hours per Resident per Day
3.81465
Adjusted CNA Staffing Hours per Resident per Day
1.25384
Adjusted LPN Staffing Hours per Resident per Day
1.15132
Adjusted RN Staffing Hours per Resident per Day
0.56475
Adjusted Total Nurse Staffing Hours per Resident per Day
2.82884
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-02-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-08-13
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
17
Cycle 3 Number of Standard Health Deficiencies
17
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
124
Cycle 3 Standard Health Survey Date
2013-01-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
124
Total Weighted Health Survey Score
34.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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
Nursiong Homes Nearby
Mary Lanning Healthcare Long Term Care
715 North St. Joseph Avenue |
HASTINGS NE 68901 | 14.3 miles away
Good Samaritan Society - Hastings Village
P O Box 2149, 926 East E Street |
HASTINGS NE 68902 | 15.4 miles away
Reviews: Be the first to review this provider.
Share your experience with Haven Home. You can help others by writing a review.
