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Detailed information-HAZEL HAWKINS MEMORIAL HOSPITAL D/P SNF

This is the detailed information about HAZEL HAWKINS MEMORIAL HOSPITAL D/P SNF, including its zip code, address, phone, federal provider number, state, overall rating, etc.

Federal Provider Number: 055462
Provider Name: HAZEL HAWKINS MEMORIAL HOSPITAL D/P SNF
Provider State: CA
Provider Zip Code: 95023
Overall Rating: 4
Ownership Type: Government - Hospital district
Number of Substantiated Complaints: 2
Provider Phone Number: 8316375711
Provider City: HOLLISTER
Provider SSA County Code: 450
Provider County Name: San Benito
Provider Address: 911 SUNSET DRIVE
Number of Certified Beds: 119
Number of Residents in Certified Beds: 101.9
Provider Type: Medicare and Medicaid
Provider Resides in Hospital: Y
Legal Business Name: HAZEL HAWKINS MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services: 1968-07-01
Continuing Care Retirement Community: N
Special Focus Facility: N
Most Recent Health Inspection More Than 2 Years Ago: N

Provider Changed Ownership in Last 12 Months: N
With a Resident and Family Council: Both
Automatic Sprinkler Systems in All Required Areas: Yes
Overall Rating Footnote:
Health Inspection Rating: 4
Health Inspection Rating Footnote:
QM Rating: 3
QM Rating Footnote:
Staffing Rating: 2
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: 1.60105
Reported LPN Staffing Hours per Resident per Day: 0.71991
Reported RN Staffing Hours per Resident per Day: 0.50382
Reported Licensed Staffing Hours per Resident per Day: 1.22373
Reported Total Nurse Staffing Hours per Resident per Day: 2.82478
Reported Physical Therapist Staffing Hours per Resident Per Day: 0.13084
Expected CNA Staffing Hours per Resident per Day: 2.05392
Expected LPN Staffing Hours per Resident per Day: 0.66556
Expected RN Staffing Hours per Resident per Day: 0.30907
Expected Total Nurse Staffing Hours per Resident per Day: 3.02855

Adjusted CNA Staffing Hours per Resident per Day: 1.62858
Adjusted LPN Staffing Hours per Resident per Day: 0.82082
Adjusted RN Staffing Hours per Resident per Day: 0.62013
Adjusted Total Nurse Staffing Hours per Resident per Day: 3.01129
Health Survey Date Under New Process: No Health Inspection since 11/28/2017
Number of Health Deficiencies on Survey Under New Process: Not Applicable
Severity of Most Severe Deficiency Cited Under New Process: Not Applicable
Largest Number of Residents Affected by Deficiency Cited Under New Process: Not Applicable
Date of Previous Standard Health Inspection: 03/23/2017
Number of Health Deficiencies on Previous Standard Health Inspection: 5
Rating Cycle 1 Standard Survey Health Date: 2017-03-23
Rating Cycle 1 Total Number of Health Deficiencies: 9
Rating Cycle 1 Number of Standard Health Deficiencies: 5
Rating Cycle 1 Number of Complaint Health Deficiencies: 4
Rating Cycle 1 Health Deficiency Score: 40
Rating Cycle 1 Number of Health Revisits: 1
Rating Cycle 1 Health Revisit Score: 0
Rating Cycle 1 Total Health Score: 40

Rating Cycle 2 Standard Health Survey Date: 2016-04-14
Rating Cycle 2 Total Number of Health Deficiencies: 8
Rating Cycle 2 Number of Standard Health Deficiencies: 8
Rating Cycle 2 Number of Complaint Health Deficiencies: 0
Rating Cycle 2 Health Deficiency Score: 36
Rating Cycle 2 Number of Health Revisits: 1
Rating Cycle 2 Health Revisit Score: 0
Rating Cycle 2 Total Health Score: 36
Total Weighted Health Survey Score: 38.400
Number of Facility Reported Incidents: 1
Number of Fines: 0
Total Amount of Fines in Dollars: 0
Number of Payment Denials: 0
Total Number of Penalties: 0
Processing Date: 2018-04-01