Kern Valley Healthcare District Dp Snf - Lake Isabella Nursing Home
General Information
UPDATEFederal Provider Number
555517
Provider Name
KERN VALLEY HEALTHCARE DISTRICT DP SNF
Provider Address
6412 LAUREL AVE
LAKE ISABELLA, CA 93240
LAKE ISABELLA, CA 93240
Provider Phone Number
7603792681
Provider SSA County
140
Provider County Name
Kern
Ownership Type
Government - Hospital district
Number of Certified Beds
74
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
KERN VALLEY HEALTHCARE DISTRICT
Date First Approved to Provide Medicare and Medicaid services
1992-07-30
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.10469
Reported LPN Staffing Hours per Resident per Day
0.98047
Reported RN Staffing Hours per Resident per Day
0.53359
Reported Licensed Staffing Hours per Resident per Day
1.51406
Reported Total Nurse Staffing Hours per Resident per Day
3.61875
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.07662
Expected LPN Staffing Hours per Resident per Day
0.57737
Expected RN Staffing Hours per Resident per Day
0.81101
Expected Total Nurse Staffing Hours per Resident per Day
3.46500
Adjusted CNA Staffing Hours per Resident per Day
2.48686
Adjusted LPN Staffing Hours per Resident per Day
1.40948
Adjusted RN Staffing Hours per Resident per Day
0.49161
Adjusted Total Nurse Staffing Hours per Resident per Day
4.20976
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
25
Cycle 2 Number of Standard Health Deficiencies
19
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
284
Cycle 2 Standard Health Survey Date
2013-05-23
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
142
Cycle 2 Total Health Score
142
Cycle 3 Total Number of Health Deficiencies
18
Cycle 3 Number of Standard Health Deficiencies
17
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
144
Cycle 3 Standard Health Survey Date
2012-07-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
144
Total Weighted Health Survey Score
194.00000
Number of Facility Reported Incidents
10
Number of Substantiated Complaints
3
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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