Alice Manor Convalescent Hospital - Fowler Nursing Home
General Information
UPDATEFederal Provider Number
05A130
Provider Name
ALICE MANOR CONVALESCENT HOSPITAL
Provider Address
8448 EAST ADAMS AVENUE
FOWLER, CA 93625
FOWLER, CA 93625
Provider Phone Number
(559) 834-2519
Provider SSA County
90
Provider County Name
Fresno
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
45
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.44556
Reported LPN Staffing Hours per Resident per Day
0.56000
Reported RN Staffing Hours per Resident per Day
0.25889
Reported Licensed Staffing Hours per Resident per Day
0.81889
Reported Total Nurse Staffing Hours per Resident per Day
3.26445
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.99739
Expected LPN Staffing Hours per Resident per Day
0.49859
Expected RN Staffing Hours per Resident per Day
0.67967
Expected Total Nurse Staffing Hours per Resident per Day
3.17565
Adjusted CNA Staffing Hours per Resident per Day
3.00425
Adjusted LPN Staffing Hours per Resident per Day
0.93223
Adjusted RN Staffing Hours per Resident per Day
0.28461
Adjusted Total Nurse Staffing Hours per Resident per Day
4.14361
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2015-04-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2014-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-04-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
40.66700
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
1
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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