Kith Haven - Flint Nursing Home
General Information
UPDATEFederal Provider Number
235343
Provider Name
KITH HAVEN
Provider Address
G 1069 BALLENGER HWY
FLINT, MI 48504
FLINT, MI 48504
Provider Phone Number
(810) 235-6676
Provider SSA County
240
Provider County Name
Genesee
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
159
Number of Residents in Certified Beds
132
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KITH HAVEN ACQUISITION COMPANY, LLC
Date First Approved to Provide Medicare and Medicaid services
1977-10-01
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.43220
Reported LPN Staffing Hours per Resident per Day
0.76629
Reported RN Staffing Hours per Resident per Day
0.75341
Reported Licensed Staffing Hours per Resident per Day
1.51970
Reported Total Nurse Staffing Hours per Resident per Day
3.95190
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07538
Expected CNA Staffing Hours per Resident per Day
2.37801
Expected LPN Staffing Hours per Resident per Day
0.61361
Expected RN Staffing Hours per Resident per Day
1.01920
Expected Total Nurse Staffing Hours per Resident per Day
4.01082
Adjusted CNA Staffing Hours per Resident per Day
2.50961
Adjusted LPN Staffing Hours per Resident per Day
1.03653
Adjusted RN Staffing Hours per Resident per Day
0.55234
Adjusted Total Nurse Staffing Hours per Resident per Day
3.97169
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-08-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-09-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
65.33300
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
13
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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