Kaweah Manor Conv Hospital - Visalia Nursing Home
General Information
UPDATEFederal Provider Number
55916
Provider Name
KAWEAH MANOR CONV HOSPITAL
Provider Address
3710 WEST TULARE AVE
VISALIA, CA 93277
VISALIA, CA 93277
Provider Phone Number
(559) 732-2244
Provider SSA County
640
Provider County Name
Tulare
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
83
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KAWEAH MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
1974-01-17
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
3
Health Inspection Rating Footnote
QM Rating
5
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
2.77289
Reported LPN Staffing Hours per Resident per Day
0.94096
Reported RN Staffing Hours per Resident per Day
0.51928
Reported Licensed Staffing Hours per Resident per Day
1.46024
Reported Total Nurse Staffing Hours per Resident per Day
4.23313
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09277
Expected CNA Staffing Hours per Resident per Day
2.51689
Expected LPN Staffing Hours per Resident per Day
0.63419
Expected RN Staffing Hours per Resident per Day
0.95302
Expected Total Nurse Staffing Hours per Resident per Day
4.10410
Adjusted CNA Staffing Hours per Resident per Day
2.70327
Adjusted LPN Staffing Hours per Resident per Day
1.23149
Adjusted RN Staffing Hours per Resident per Day
0.40713
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15763
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-12-18
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
15
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
45.33300
Number of Facility Reported Incidents
3
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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