Cloverdale Healthcare Center - Cloverdale Nursing Home
General Information
UPDATEFederal Provider Number
55756
Provider Name
CLOVERDALE HEALTHCARE CENTER
Provider Address
300 CHERRY CREEK RD
CLOVERDALE, CA 95425
CLOVERDALE, CA 95425
Provider Phone Number
7078945201
Provider SSA County
590
Provider County Name
Sonoma
Ownership Type
For profit - Corporation
Number of Certified Beds
72
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ENSIGN CLOVERDALE LLC
Date First Approved to Provide Medicare and Medicaid services
1974-07-16
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
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
2.94224
Reported LPN Staffing Hours per Resident per Day
0.77328
Reported RN Staffing Hours per Resident per Day
0.71207
Reported Licensed Staffing Hours per Resident per Day
1.48534
Reported Total Nurse Staffing Hours per Resident per Day
4.42759
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14310
Expected CNA Staffing Hours per Resident per Day
2.36960
Expected LPN Staffing Hours per Resident per Day
0.57110
Expected RN Staffing Hours per Resident per Day
0.91260
Expected Total Nurse Staffing Hours per Resident per Day
3.85329
Adjusted CNA Staffing Hours per Resident per Day
3.04667
Adjusted LPN Staffing Hours per Resident per Day
1.12384
Adjusted RN Staffing Hours per Resident per Day
0.58302
Adjusted Total Nurse Staffing Hours per Resident per Day
4.63167
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-11-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Healdsburg District Hospital Dp/snf
1375 University Avenue |
HEALDSBURG CA 95448 | 14.5 miles away
Healdsburg Senior Living Community
725 Grove Street |
HEALDSBURG CA 95448 | 14.7 miles away
Brookdale Fountaingrove
300 Fountaingrove Parkway |
SANTA ROSA CA 95403 | 27.5 miles away
Friends House
684 Benicia Drive |
SANTA ROSA CA 95409 | 29.4 miles away
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