Ann Pearl Nursing Facility - Kaneohe Nursing Home
General Information
UPDATEFederal Provider Number
125048
Provider Name
ANN PEARL NURSING FACILITY
Provider Address
45-181 WAIKALUA ROAD
KANEOHE, HI 96744
KANEOHE, HI 96744
Provider Phone Number
8082478558
Provider SSA County
20
Provider County Name
Honolulu
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1998-12-28
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
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
2.56649
Reported LPN Staffing Hours per Resident per Day
0.11856
Reported RN Staffing Hours per Resident per Day
1.49381
Reported Licensed Staffing Hours per Resident per Day
1.61237
Reported Total Nurse Staffing Hours per Resident per Day
4.17886
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13402
Expected CNA Staffing Hours per Resident per Day
2.69676
Expected LPN Staffing Hours per Resident per Day
0.76323
Expected RN Staffing Hours per Resident per Day
1.22267
Expected Total Nurse Staffing Hours per Resident per Day
4.68266
Adjusted CNA Staffing Hours per Resident per Day
2.33517
Adjusted LPN Staffing Hours per Resident per Day
0.12893
Adjusted RN Staffing Hours per Resident per Day
0.91290
Adjusted Total Nurse Staffing Hours per Resident per Day
3.59722
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2012-12-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2011-08-02
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
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2010-04-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
45.33300
Number of Facility Reported Incidents
0
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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