Kau Hospital - Pahala Nursing Home
General Information
UPDATEFederal Provider Number
125028
Provider Name
KAU HOSPITAL
Provider Address
1 KAMANI STREET
PAHALA, HI 96777
PAHALA, HI 96777
Provider Phone Number
8089282050
Provider SSA County
10
Provider County Name
Hawaii
Ownership Type
Government - State
Number of Certified Beds
16
Number of Residents in Certified Beds
11
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
KAU HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1976-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
6.71364
Reported LPN Staffing Hours per Resident per Day
1.83636
Reported RN Staffing Hours per Resident per Day
3.65909
Reported Licensed Staffing Hours per Resident per Day
5.49545
Reported Total Nurse Staffing Hours per Resident per Day
12.20909
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.71576
Expected LPN Staffing Hours per Resident per Day
0.66000
Expected RN Staffing Hours per Resident per Day
0.80561
Expected Total Nurse Staffing Hours per Resident per Day
4.18136
Adjusted CNA Staffing Hours per Resident per Day
6.06581
Adjusted LPN Staffing Hours per Resident per Day
2.30936
Adjusted RN Staffing Hours per Resident per Day
3.39381
Adjusted Total Nurse Staffing Hours per Resident per Day
11.76975
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-08-15
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2011-03-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
38.00000
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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