Ketchikan Med Ctr New Horizons Transitional Care - Ketchikan Nursing Home

General Information

UPDATE
Federal Provider Number
25010
Provider Name
KETCHIKAN MED CTR NEW HORIZONS TRANSITIONAL CARE
Provider Address
3100 TONGASS AVENUE
KETCHIKAN, AK 99901
Provider Phone Number
9072255171
Provider SSA County
130
Provider County Name
Ketchikan Gateway
Ownership Type
Non profit - Corporation
Number of Certified Beds
29
Number of Residents in Certified Beds
20
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
PEACEHEALTH
Date First Approved to Provide Medicare and Medicaid services
1968-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
5
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
2.15750
Reported LPN Staffing Hours per Resident per Day
0.28500
Reported RN Staffing Hours per Resident per Day
2.24750
Reported Licensed Staffing Hours per Resident per Day
2.53250
Reported Total Nurse Staffing Hours per Resident per Day
4.69000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10750
Expected CNA Staffing Hours per Resident per Day
2.58868
Expected LPN Staffing Hours per Resident per Day
0.53380
Expected RN Staffing Hours per Resident per Day
0.86061
Expected Total Nurse Staffing Hours per Resident per Day
3.98308
Adjusted CNA Staffing Hours per Resident per Day
2.04501
Adjusted LPN Staffing Hours per Resident per Day
0.44315
Adjusted RN Staffing Hours per Resident per Day
1.95132
Adjusted Total Nurse Staffing Hours per Resident per Day
4.74630
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
132
Cycle 1 Standard Survey Health Date
2014-06-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
132
Cycle 2 Total Number of Health Deficiencies
20
Cycle 2 Number of Standard Health Deficiencies
18
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
471
Cycle 2 Standard Health Survey Date
2013-07-12
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
225.66700
Number of Facility Reported Incidents
0
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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