Kahuku Medical Center - Kahuku Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
125030
Provider Name
KAHUKU MEDICAL CENTER
Provider Address
56-117 PUALALEA STREET
KAHUKU, HI 96731
KAHUKU, HI 96731
Provider Phone Number
(808) 293-9221
Provider SSA County
20
Provider County Name
Honolulu
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
10
Number of Residents in Certified Beds
10
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
KAHUKU MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
1977-01-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
0
QM Rating Footnote
Data Not Available
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
3.60000
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
3.54000
Reported Licensed Staffing Hours per Resident per Day
3.54000
Reported Total Nurse Staffing Hours per Resident per Day
7.14000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.63033
Expected LPN Staffing Hours per Resident per Day
0.63417
Expected RN Staffing Hours per Resident per Day
0.91383
Expected Total Nurse Staffing Hours per Resident per Day
4.17833
Adjusted CNA Staffing Hours per Resident per Day
3.35825
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
2.89450
Adjusted Total Nurse Staffing Hours per Resident per Day
6.88806
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
2013-07-11
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
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2012-06-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-03-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
20.00000
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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