Apple Valley Post Acute Center - Apple Valley Nursing Home
General Information
UPDATEFederal Provider Number
555476
Provider Name
APPLE VALLEY POST ACUTE CENTER
Provider Address
11959 APPLE VALLEY ROAD
APPLE VALLEY, CA 92308
APPLE VALLEY, CA 92308
Provider Phone Number
7602405051
Provider SSA County
460
Provider County Name
San Bernardino
Ownership Type
For profit - Partnership
Number of Certified Beds
99
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1991-09-26
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.23901
Reported LPN Staffing Hours per Resident per Day
1.34286
Reported RN Staffing Hours per Resident per Day
0.45824
Reported Licensed Staffing Hours per Resident per Day
1.80110
Reported Total Nurse Staffing Hours per Resident per Day
4.04011
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01264
Expected CNA Staffing Hours per Resident per Day
2.31348
Expected LPN Staffing Hours per Resident per Day
0.68521
Expected RN Staffing Hours per Resident per Day
1.39103
Expected Total Nurse Staffing Hours per Resident per Day
4.38971
Adjusted CNA Staffing Hours per Resident per Day
2.37472
Adjusted LPN Staffing Hours per Resident per Day
1.62662
Adjusted RN Staffing Hours per Resident per Day
0.24615
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70988
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
287
Cycle 1 Standard Survey Health Date
2014-12-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
287
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2014-02-25
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
19
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
183
Cycle 3 Standard Health Survey Date
2013-03-12
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
92
Cycle 3 Total Health Score
275
Total Weighted Health Survey Score
220.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
11
Number of Fines
2
Total Amount of Fines in Dollars
117424
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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