Apple Valley Post-acute Rehab - Sebastopol Nursing Home
General Information
UPDATEFederal Provider Number
55919
Provider Name
APPLE VALLEY POST-ACUTE REHAB
Provider Address
1035 GRAVENSTEIN HWY SOUTH
SEBASTOPOL, CA 95472
SEBASTOPOL, CA 95472
Provider Phone Number
(707) 823-7675
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
95
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
A.V.C.H. INC.
Date First Approved to Provide Medicare and Medicaid services
1968-10-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.17679
Reported LPN Staffing Hours per Resident per Day
0.77619
Reported RN Staffing Hours per Resident per Day
1.10952
Reported Licensed Staffing Hours per Resident per Day
1.88571
Reported Total Nurse Staffing Hours per Resident per Day
5.06250
Reported Physical Therapist Staffing Hours per Resident Per Day
0.35655
Expected CNA Staffing Hours per Resident per Day
2.67565
Expected LPN Staffing Hours per Resident per Day
0.66111
Expected RN Staffing Hours per Resident per Day
1.10130
Expected Total Nurse Staffing Hours per Resident per Day
4.43806
Adjusted CNA Staffing Hours per Resident per Day
2.91327
Adjusted LPN Staffing Hours per Resident per Day
0.97448
Adjusted RN Staffing Hours per Resident per Day
0.75278
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59805
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
20
Cycle 1 Standard Survey Health Date
2015-04-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
92
Cycle 2 Standard Health Survey Date
2014-05-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-06-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
42.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
1200
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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