California Nursing Homes >> Hollister Nursing Homes >> Hazel Hawkins Memorial Hospital D/p Snf

Hazel Hawkins Memorial Hospital D/p Snf - Hollister Nursing Home

General Information

UPDATE
Federal Provider Number
55462
Provider Name
HAZEL HAWKINS MEMORIAL HOSPITAL D/P SNF
Provider Address
911 SUNSET DRIVE
HOLLISTER, CA 95023
Provider Phone Number
8316375711
Provider SSA County
450
Provider County Name
San Benito
Ownership Type
Government - Hospital district
Number of Certified Beds
119
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
HAZEL HAWKINS MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1968-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.77850
Reported LPN Staffing Hours per Resident per Day
0.54700
Reported RN Staffing Hours per Resident per Day
1.16300
Reported Licensed Staffing Hours per Resident per Day
1.71000
Reported Total Nurse Staffing Hours per Resident per Day
4.48850
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05700
Expected CNA Staffing Hours per Resident per Day
2.45234
Expected LPN Staffing Hours per Resident per Day
0.65612
Expected RN Staffing Hours per Resident per Day
1.02131
Expected Total Nurse Staffing Hours per Resident per Day
4.12978
Adjusted CNA Staffing Hours per Resident per Day
2.78004
Adjusted LPN Staffing Hours per Resident per Day
0.69196
Adjusted RN Staffing Hours per Resident per Day
0.85086
Adjusted Total Nurse Staffing Hours per Resident per Day
4.38103
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-06-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
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
76
Cycle 2 Standard Health Survey Date
2013-07-29
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
23
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
10
Cycle 3 Health Deficiency Score
104
Cycle 3 Standard Health Survey Date
2012-08-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
104
Total Weighted Health Survey Score
62.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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