Holly Hill House - Sulphur Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
195431
Provider Name
HOLLY HILL HOUSE
Provider Address
100 KINGSTON ROAD
SULPHUR, LA 70663
SULPHUR, LA 70663
Provider Phone Number
(337) 625-5843
Provider SSA County
90
Provider County Name
Calcasieu
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
200
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HOLLY HILL HOUSE, LLC
Date First Approved to Provide Medicare and Medicaid services
1997-09-01
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
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.11772
Reported LPN Staffing Hours per Resident per Day
0.81203
Reported RN Staffing Hours per Resident per Day
0.69684
Reported Licensed Staffing Hours per Resident per Day
1.50886
Reported Total Nurse Staffing Hours per Resident per Day
3.62659
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08418
Expected CNA Staffing Hours per Resident per Day
2.33600
Expected LPN Staffing Hours per Resident per Day
0.62731
Expected RN Staffing Hours per Resident per Day
1.02210
Expected Total Nurse Staffing Hours per Resident per Day
3.98541
Adjusted CNA Staffing Hours per Resident per Day
2.22442
Adjusted LPN Staffing Hours per Resident per Day
1.07441
Adjusted RN Staffing Hours per Resident per Day
0.50942
Adjusted Total Nurse Staffing Hours per Resident per Day
3.66799
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-03-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
17.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
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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