Acacia Park Nursing & Rehab Center - Modesto Nursing Home
General Information
UPDATEFederal Provider Number
55011
Provider Name
ACACIA PARK NURSING & REHAB CENTER
Provider Address
1611 SCENIC DRIVE
MODESTO, CA 95355
MODESTO, CA 95355
Provider Phone Number
(209) 523-5667
Provider SSA County
600
Provider County Name
Stanislaus
Provider Website
Provider Description
Ownership Type
For profit - Limited Liability
Number of Certified Beds
99
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SKY PARK HEALTH CARE INC.
Date First Approved to Provide Medicare and Medicaid services
1969-06-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.45333
Reported LPN Staffing Hours per Resident per Day
0.86933
Reported RN Staffing Hours per Resident per Day
0.42600
Reported Licensed Staffing Hours per Resident per Day
1.29533
Reported Total Nurse Staffing Hours per Resident per Day
3.74866
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05333
Expected CNA Staffing Hours per Resident per Day
2.41572
Expected LPN Staffing Hours per Resident per Day
0.58887
Expected RN Staffing Hours per Resident per Day
0.97109
Expected Total Nurse Staffing Hours per Resident per Day
3.97569
Adjusted CNA Staffing Hours per Resident per Day
2.49190
Adjusted LPN Staffing Hours per Resident per Day
1.22529
Adjusted RN Staffing Hours per Resident per Day
0.32778
Adjusted Total Nurse Staffing Hours per Resident per Day
3.80072
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-10-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
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
24
Total Weighted Health Survey Score
24.00000
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
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