Providence Valdez Medical Center - Valdez Nursing Home

General Information

UPDATE
Federal Provider Number
25034
Provider Name
PROVIDENCE VALDEZ MEDICAL CENTER
Provider Address
911 MEALS AVENUE
VALDEZ, AK 99686
Provider Phone Number
9078341825
Provider SSA County
260
Provider County Name
Valdez Cordova
Ownership Type
Government - City
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
CITY OF VALDEZ
Date First Approved to Provide Medicare and Medicaid services
2005-10-03
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
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
4.73500
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
3.50000
Reported Licensed Staffing Hours per Resident per Day
3.50000
Reported Total Nurse Staffing Hours per Resident per Day
8.23500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.19700
Expected LPN Staffing Hours per Resident per Day
0.50250
Expected RN Staffing Hours per Resident per Day
0.68133
Expected Total Nurse Staffing Hours per Resident per Day
3.38083
Adjusted CNA Staffing Hours per Resident per Day
5.28824
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
3.83836
Adjusted Total Nurse Staffing Hours per Resident per Day
9.81843
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-08-21
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
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-08-14
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-05-23
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
21.33300
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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