Providence Kodiak Island Med Ltc
Providence Kodiak Island Med Ltc Information
| Facility Name | Providence Kodiak Island Med Ltc |
| Location | 1915 E Rezanof Drive, Kodiak, AK 99615 |
| County (SSA Code) | Kodiak Island Borough (150) |
| Phone Number | 907-486-7800 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 22 |
| Average Number of Residents | 22 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Both |
| Provider Business Name | Legal Business Name Not Available |
| Ownership Type | Non profit - Corporation |
| Date First Approved | 1994-09-20 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 5.91596 |
| Reported LPN Staffing Hours per Resident per Day | 0.3283 |
| Reported RN Staffing - Hours per Resident per Day | 1.86064 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 2.18894 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 8.1049 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.04895 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.17067 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.64584 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.3729 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.18942 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 8.10177 |
| Total Weighted Health Survey Score for three cycles | 55.167 |
| Rating cycle 1 Standard Survey Health Date | 2019-03-15 |
| Rating cycle 1 - Health Deficiency Score | 2 |
| Rating cycle 1 - Total Health Inspection Score | 40 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-05-18 |
| Rating cycle 2 - Health Deficiency Score | 40 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-03-20 |
| Rating cycle 3 - Health Deficiency Score | 191 |
| Rating cycle 3 - Total Health Inspection Score | 191 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 0 |
| Number of Substantiated Complaints | 0 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |