Hawaii Nursing Homes >> Kapaa Nursing Homes >> Samuel Mahelona Memorial Hospital

Samuel Mahelona Memorial Hospital - Kapaa Nursing Home

General Information

UPDATE
Federal Provider Number
125029
Provider Name
SAMUEL MAHELONA MEMORIAL HOSPITAL
Provider Address
4800 KAWAIHAU ROAD
KAPAA, HI 96746
Provider Phone Number
8088224961
Provider SSA County
40
Provider County Name
Kauai
Ownership Type
Government - State
Number of Certified Beds
66
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1976-07-15
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
4
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
2.85741
Reported LPN Staffing Hours per Resident per Day
1.69352
Reported RN Staffing Hours per Resident per Day
2.87870
Reported Licensed Staffing Hours per Resident per Day
4.57222
Reported Total Nurse Staffing Hours per Resident per Day
7.42963
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10556
Expected CNA Staffing Hours per Resident per Day
2.35892
Expected LPN Staffing Hours per Resident per Day
0.55960
Expected RN Staffing Hours per Resident per Day
0.74584
Expected Total Nurse Staffing Hours per Resident per Day
3.66437
Adjusted CNA Staffing Hours per Resident per Day
2.97221
Adjusted LPN Staffing Hours per Resident per Day
2.51182
Adjusted RN Staffing Hours per Resident per Day
2.88395
Adjusted Total Nurse Staffing Hours per Resident per Day
8.17279
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
2014-11-21
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2012-07-27
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2010-07-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
28.00000
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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