Utuqqanaat Inaat - Kotzebue Nursing Home
General Information
UPDATEFederal Provider Number
25035
Provider Name
UTUQQANAAT INAAT
Provider Address
436 MISSION STREET
KOTZEBUE, AK 99752
KOTZEBUE, AK 99752
Provider Phone Number
9074423321
Provider SSA County
140
Provider County Name
Northwest Arctic
Ownership Type
Non profit - Corporation
Number of Certified Beds
18
Number of Residents in Certified Beds
18
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANIILAQ ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
2012-03-15
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
2
Health Inspection Rating Footnote
QM Rating
1
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
5.08056
Reported LPN Staffing Hours per Resident per Day
0.33611
Reported RN Staffing Hours per Resident per Day
1.71944
Reported Licensed Staffing Hours per Resident per Day
2.05556
Reported Total Nurse Staffing Hours per Resident per Day
7.13611
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03056
Expected CNA Staffing Hours per Resident per Day
1.95824
Expected LPN Staffing Hours per Resident per Day
0.50706
Expected RN Staffing Hours per Resident per Day
0.66098
Expected Total Nurse Staffing Hours per Resident per Day
3.12627
Adjusted CNA Staffing Hours per Resident per Day
6.36602
Adjusted LPN Staffing Hours per Resident per Day
0.55018
Adjusted RN Staffing Hours per Resident per Day
1.94373
Adjusted Total Nurse Staffing Hours per Resident per Day
9.20103
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-01-09
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
24
Cycle 3 Number of Standard Health Deficiencies
21
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
565
Cycle 3 Standard Health Survey Date
2013-01-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
565
Total Weighted Health Survey Score
134.83300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
2
Total Amount of Fines in Dollars
6500
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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