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Detailed information-KIT CARSON NURSING & REHABILITATION CENTER

This is the detailed information about KIT CARSON NURSING & REHABILITATION CENTER, including its zip code, address, phone, federal provider number, state, overall rating, etc.

Federal Provider Number: 056198
Provider Name: KIT CARSON NURSING & REHABILITATION CENTER
Provider State: CA
Provider Zip Code: 95642
Overall Rating: 5
Ownership Type: For profit - Corporation
Number of Substantiated Complaints: 18
Provider Phone Number: 2092232231
Provider City: JACKSON
Provider SSA County Code: 020
Provider County Name: Amador
Provider Address: 811 COURT STREET
Number of Certified Beds: 199
Number of Residents in Certified Beds: 105.3
Provider Type: Medicare and Medicaid
Provider Resides in Hospital: N
Legal Business Name: RAY PROPERTIES KIT CARSON INC.
Date First Approved to Provide Medicare and Medicaid services: 1970-05-04
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: Resident
Automatic Sprinkler Systems in All Required Areas: Yes
Overall Rating Footnote:
Health Inspection Rating: 4
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: 2.17370
Reported LPN Staffing Hours per Resident per Day: 1.09136
Reported RN Staffing Hours per Resident per Day: 0.49567
Reported Licensed Staffing Hours per Resident per Day: 1.58703
Reported Total Nurse Staffing Hours per Resident per Day: 3.76073
Reported Physical Therapist Staffing Hours per Resident Per Day: 0.10333
Expected CNA Staffing Hours per Resident per Day: 1.92545
Expected LPN Staffing Hours per Resident per Day: 0.71017
Expected RN Staffing Hours per Resident per Day: 0.31918
Expected Total Nurse Staffing Hours per Resident per Day: 2.95480

Adjusted CNA Staffing Hours per Resident per Day: 2.35861
Adjusted LPN Staffing Hours per Resident per Day: 1.16618
Adjusted RN Staffing Hours per Resident per Day: 0.59076
Adjusted Total Nurse Staffing Hours per Resident per Day: 4.10910
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: 07/20/2017
Number of Health Deficiencies on Previous Standard Health Inspection: 7
Rating Cycle 1 Standard Survey Health Date: 2017-07-20
Rating Cycle 1 Total Number of Health Deficiencies: 8
Rating Cycle 1 Number of Standard Health Deficiencies: 7
Rating Cycle 1 Number of Complaint Health Deficiencies: 1
Rating Cycle 1 Health Deficiency Score: 44
Rating Cycle 1 Number of Health Revisits: 1
Rating Cycle 1 Health Revisit Score: 0
Rating Cycle 1 Total Health Score: 44

Rating Cycle 2 Standard Health Survey Date: 2016-07-21
Rating Cycle 2 Total Number of Health Deficiencies: 9
Rating Cycle 2 Number of Standard Health Deficiencies: 1
Rating Cycle 2 Number of Complaint Health Deficiencies: 8
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: 40.800
Number of Facility Reported Incidents: 17
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