Southern Inyo Hospital D/p Snf - Lone Pine Nursing Home
General Information
UPDATEFederal Provider Number
555527
Provider Name
SOUTHERN INYO HOSPITAL D/P SNF
Provider Address
501 E LOCUST
LONE PINE, CA 93545
LONE PINE, CA 93545
Provider Phone Number
(760) 876-5501
Provider SSA County
130
Provider County Name
Inyo
Provider Website
Provider Description
Ownership Type
Government - Hospital district
Number of Certified Beds
33
Number of Residents in Certified Beds
26
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
SOUTHERN INYO HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1992-12-03
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
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
2.71538
Reported LPN Staffing Hours per Resident per Day
1.13269
Reported RN Staffing Hours per Resident per Day
1.20385
Reported Licensed Staffing Hours per Resident per Day
2.33654
Reported Total Nurse Staffing Hours per Resident per Day
5.05192
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18846
Expected CNA Staffing Hours per Resident per Day
1.97000
Expected LPN Staffing Hours per Resident per Day
0.50094
Expected RN Staffing Hours per Resident per Day
0.65188
Expected Total Nurse Staffing Hours per Resident per Day
3.12283
Adjusted CNA Staffing Hours per Resident per Day
3.38210
Adjusted LPN Staffing Hours per Resident per Day
1.87673
Adjusted RN Staffing Hours per Resident per Day
1.37987
Adjusted Total Nurse Staffing Hours per Resident per Day
6.52095
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2014-07-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-08-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-10-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
64.66700
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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