Bethel Lutheran Home - Selma Nursing Home
General Information
UPDATEFederal Provider Number
05A021
Provider Name
BETHEL LUTHERAN HOME
Provider Address
2280 DOCKERY AVENUE
SELMA, CA 93662
SELMA, CA 93662
Provider Phone Number
(559) 896-4900
Provider SSA County
90
Provider County Name
Fresno
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
59
Number of Residents in Certified Beds
57
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
1974-04-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.87544
Reported LPN Staffing Hours per Resident per Day
0.68421
Reported RN Staffing Hours per Resident per Day
0.57632
Reported Licensed Staffing Hours per Resident per Day
1.26053
Reported Total Nurse Staffing Hours per Resident per Day
4.13597
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.46554
Expected LPN Staffing Hours per Resident per Day
0.52107
Expected RN Staffing Hours per Resident per Day
0.74360
Expected Total Nurse Staffing Hours per Resident per Day
3.73021
Adjusted CNA Staffing Hours per Resident per Day
2.86164
Adjusted LPN Staffing Hours per Resident per Day
1.08986
Adjusted RN Staffing Hours per Resident per Day
0.57911
Adjusted Total Nurse Staffing Hours per Resident per Day
4.46937
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-12-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-12-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
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
24
Cycle 3 Standard Health Survey Date
2012-12-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
46.00000
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
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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