Christ The King Manor - Dubois Nursing Home
General Information
UPDATEFederal Provider Number
395460
Provider Name
CHRIST THE KING MANOR
Provider Address
1100 WEST LONG AVENUE
DUBOIS, PA 15801
DUBOIS, PA 15801
Provider Phone Number
(814) 371-3180
Provider SSA County
230
Provider County Name
Clearfield
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
160
Number of Residents in Certified Beds
155
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHRIST THE KING MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
1980-04-01
Continuing Care Retirement Community
Y
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
4
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
2.77935
Reported LPN Staffing Hours per Resident per Day
1.24194
Reported RN Staffing Hours per Resident per Day
1.24129
Reported Licensed Staffing Hours per Resident per Day
2.48323
Reported Total Nurse Staffing Hours per Resident per Day
5.26258
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02226
Expected CNA Staffing Hours per Resident per Day
2.66520
Expected LPN Staffing Hours per Resident per Day
0.68995
Expected RN Staffing Hours per Resident per Day
1.17528
Expected Total Nurse Staffing Hours per Resident per Day
4.53043
Adjusted CNA Staffing Hours per Resident per Day
2.55879
Adjusted LPN Staffing Hours per Resident per Day
1.49404
Adjusted RN Staffing Hours per Resident per Day
0.78917
Adjusted Total Nurse Staffing Hours per Resident per Day
4.68233
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-09-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-09-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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