Overall Rating
Cited for abuse
Address
1391 Madison Avenue
El Cajon, CA 92021
Contact
6194441107
Certification Date
1967-01-01
CMS Certification Number
055064
Ownership Type
For profit - Individual
Number of Certified Beds
96
Average Number of Residents per Day
88.9
Provider Type
Medicare and Medicaid
Legal Business Name
KOA HOLDINGS LLC
Affiliated Entity Name
PROVIDENCE GROUP
Affiliated Entity ID
429
Health Inspection Rating
2
Quality Measure Rating
4
Staffing Rating
2
Reported Nurse Aide Staffing Hours per Resident per Day
2.41321
Reported LPN Staffing Hours per Resident per Day
0.95344
Reported RN Staffing Hours per Resident per Day
0.37794
Reported Total Nurse Staffing Hours per Resident per Day
3.74459
Total Number of Nurse Staff Hours per Resident per Day on the Weekend
3.31367
Registered Nurse Hours per Resident per Day on the Weekend
0.15828
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08071
Long-Stay Quality Measure Rating
5
Short-Stay Quality Measure Rating
4
Total Weighted Health Survey Score
112.667
Number of Facility Reported Incidents
10
Number of Substantiated Complaints
21
Number of Citations from Infection Control Inspections
0
Standard Health Survey Date
2021-07-15
Total Number of Health Deficiencies
26
Number of Standard Health Deficiencies
12
Number of Complaint Health Deficiencies
15
Health Deficiency Score
160
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
160
Standard Health Survey Date
2019-07-11
Total Number of Health Deficiencies
14
Number of Standard Health Deficiencies
8
Number of Complaint Health Deficiencies
6
Health Deficiency Score
64
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
64
Standard Health Survey Date
2018-06-25
Total Number of Health Deficiencies
16
Number of Standard Health Deficiencies
10
Number of Complaint Health Deficiencies
6
Health Deficiency Score
68
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
68
Number of Fines
1
Total Amount of Fines in Dollars
11407.50
Number of Payment Denials
0
Total Number of Penalties
1