Antelope Valley Care Center - Lancaster Nursing Home
General Information
UPDATEFederal Provider Number
555456
Provider Name
ANTELOPE VALLEY CARE CENTER
Provider Address
44567 NORTH 15TH ST. WEST
LANCASTER, CA 93534
LANCASTER, CA 93534
Provider Phone Number
(661) 949-5524
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
199
Number of Residents in Certified Beds
108
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GERI-CARE IV, LLC
Date First Approved to Provide Medicare and Medicaid services
1991-02-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
2.88657
Reported LPN Staffing Hours per Resident per Day
1.36898
Reported RN Staffing Hours per Resident per Day
0.62639
Reported Licensed Staffing Hours per Resident per Day
1.99537
Reported Total Nurse Staffing Hours per Resident per Day
4.88194
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16944
Expected CNA Staffing Hours per Resident per Day
2.77227
Expected LPN Staffing Hours per Resident per Day
0.81366
Expected RN Staffing Hours per Resident per Day
1.31862
Expected Total Nurse Staffing Hours per Resident per Day
4.90454
Adjusted CNA Staffing Hours per Resident per Day
2.55487
Adjusted LPN Staffing Hours per Resident per Day
1.39648
Adjusted RN Staffing Hours per Resident per Day
0.35495
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01233
Cycle 1 Total Number of Health Deficiencies
23
Cycle 1 Number of Standard Health Deficiencies
22
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
128
Cycle 1 Standard Survey Health Date
2014-02-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
128
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2012-10-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2011-07-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
98.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
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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