Chowchilla Memorial Healthcare District - Chowchilla Nursing Home
General Information
UPDATEFederal Provider Number
555530
Provider Name
CHOWCHILLA MEMORIAL HEALTHCARE DISTRICT
Provider Address
1104 VENTURA AVE.
CHOWCHILLA, CA 93610
CHOWCHILLA, CA 93610
Provider Phone Number
(559) 665-3781
Provider SSA County
300
Provider County Name
Madera
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
28
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHOWCHILLA MEMORIAL HOSPITAL DISTRICT
Date First Approved to Provide Medicare and Medicaid services
1992-10-23
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
5
Health Inspection Rating Footnote
QM Rating
3
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
2.53036
Reported LPN Staffing Hours per Resident per Day
1.02500
Reported RN Staffing Hours per Resident per Day
0.46429
Reported Licensed Staffing Hours per Resident per Day
1.48929
Reported Total Nurse Staffing Hours per Resident per Day
4.01965
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.38488
Expected LPN Staffing Hours per Resident per Day
0.58461
Expected RN Staffing Hours per Resident per Day
0.92532
Expected Total Nurse Staffing Hours per Resident per Day
3.89481
Adjusted CNA Staffing Hours per Resident per Day
2.60338
Adjusted LPN Staffing Hours per Resident per Day
1.45524
Adjusted RN Staffing Hours per Resident per Day
0.37491
Adjusted Total Nurse Staffing Hours per Resident per Day
4.16010
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-08-07
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-08-13
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-08-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
14.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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