California Nursing Homes >> Garberville Nursing Homes >> Jerold Phelps Comm Hosp Snf

Jerold Phelps Comm Hosp Snf - Garberville Nursing Home

General Information

UPDATE
Federal Provider Number
555516
Provider Name
JEROLD PHELPS COMM HOSP SNF
Provider Address
733 CEDAR STREET
GARBERVILLE, CA 95542
Provider Phone Number
7079233921
Provider SSA County
110
Provider County Name
Humboldt
Ownership Type
Government - Hospital district
Number of Certified Beds
17
Number of Residents in Certified Beds
8
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
SOUTHERN HUMBOLDT COMMUNITY HOSPITAL DISTRICT
Date First Approved to Provide Medicare and Medicaid services
1992-08-25
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Family
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
0
QM Rating Footnote
Data Not Available
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
1.07500
Reported RN Staffing Hours per Resident per Day
2.56875
Reported Licensed Staffing Hours per Resident per Day
3.64375
Reported Total Nurse Staffing Hours per Resident per Day
3.64375
Reported Physical Therapist Staffing Hours per Resident Per Day
0.43125
Expected CNA Staffing Hours per Resident per Day
2.53906
Expected LPN Staffing Hours per Resident per Day
0.69535
Expected RN Staffing Hours per Resident per Day
0.93551
Expected Total Nurse Staffing Hours per Resident per Day
4.16992
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
1.28318
Adjusted RN Staffing Hours per Resident per Day
2.05168
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52227
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-02-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2013-02-08
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
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-02-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
20.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
5000
Number of Payment Denials
2
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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