Kaweah Manor Convalescent Hospital
3710 West Tulare Ave, Visalia, CA 93277


Kaweah Manor Convalescent Hospital is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 055916. The address is 3710 West Tulare Ave, Visalia, CA 93277. The zip code is 93277. The phone number is 5597322244.


Kaweah Manor Convalescent Hospital · 3710 West Tulare Ave, Visalia, CA 93277

Federal Provider Number 055916
Provider Name KAWEAH MANOR CONVALESCENT HOSPITAL
Address 3710 WEST TULARE AVE
VISALIA, CA 93277
Phone Number 5597322244
SSA County Code 640
County Name Tulare
Ownership Type For profit - Corporation
Certified Beds 99
Certified Beds Residents 89
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name KAWEAH MANOR, INC.
Date First Approved to Provide Medicare Medicaid Services 01/17/1974
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 1
Quality Measure Rating 5
Staffing Rating 2
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 2.60449
Reported LPN Staffing Hours per Resident per Day 0.84494
Reported RN Staffing Hours per Resident per Day 0.25843
Reported Licensed Staffing Hours per Resident per Day 1.10337
Reported Total Nurse Staffing Hours per Resident per Day 3.70786
Reported Physical Therapist Staffing Hours per Resident Per Day 0
Expected CNA Staffing Hours per Resident per Day 2.28703
Expected LPN Staffing Hours per Resident per Day 0.58484
Expected RN Staffing Hours per Resident per Day 0.8469
Expected Total Nurse Staffing Hours per Resident per Day 3.71878
Adjusted CNA Staffing Hours per Resident per Day 2.79429
Adjusted LPN Staffing Hours per Resident per Day 1.19913
Adjusted RN Staffing Hours per Resident per Day 0.22801
Adjusted Total Nurse Staffing Hours per Resident per Day 4.01906
Cycle 1 Total Number of Health Deficiencies 19
Cycle 1 Number of Standard Health Deficiencies 16
Cycle 1 Number of Complaint Health Deficiencies 3
Cycle 1 Health Deficiency Score 124
Cycle 1 Standard Survey Health Date 11/17/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Health Revisit Score 0
Cycle 1 Total Health Score 124
Cycle 2 Total Number of Health Deficiencies 21
Cycle 2 Number of Standard Health Deficiencies 15
Cycle 2 Number of Complaint Health Deficiencies 6
Cycle 2 Health Deficiency Score 144
Cycle 2 Standard Health Survey Date 11/19/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Health Revisit Score 0
Cycle 2 Total Health Score 144
Cycle 3 Total Number of Health Deficiencies 9
Cycle 3 Number of Standard Health Deficiencies 1
Cycle 3 Number of Complaint Health Deficiencies 8
Cycle 3 Health Deficiency Score 56
Cycle 3 Standard Health Survey Date 12/18/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Health Revisit Score 0
Cycle 3 Total Health Score 56
Total Weighted Health Survey Score 119.333
Number of Facility Reported Incidents 11
Number of Substantiated Complaints 3
Number of Fines 0
Total Amount of Fines in Dollars $0.00
Number of Payment Denials 0
Total Number of Penalties 0
Processing Date 08/01/2017

Owner or Manager · Kaweah Manor Convalescent Hospital

Owner Name Role Association Date
FAZALBHOY, SHUBHANGI (Individual) OPERATIONAL/MANAGERIAL CONTROL since 11/16/2008
HANSON, CARY (Individual) OPERATIONAL/MANAGERIAL CONTROL since 05/26/2009
HIGBEE, JAMES (Individual) MANAGING EMPLOYEE since 04/01/2009
MCCLUNG, BARBRA (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/29/2002
MOYLE, KENSETT (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2009
MOYLE, KENSETT (Individual) DIRECTOR since 06/15/2005
MOYLE, KENSETT (Individual) OFFICER since 04/01/2009
MOYLE, LINDSEY (Individual) OPERATIONAL/MANAGERIAL CONTROL since 05/01/2011

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