Arbor Nursing Center - Lodi Nursing Home

General Information

UPDATE
Federal Provider Number
555164
Provider Name
ARBOR NURSING CENTER
Provider Address
900 NORTH CHURCH STREET
LODI, CA 95240
Provider Phone Number
2093331222
Provider SSA County
490
Provider County Name
San Joaquin
Ownership Type
For profit - Corporation
Number of Certified Beds
149
Number of Residents in Certified Beds
128
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE LODI, LLC
Date First Approved to Provide Medicare and Medicaid services
1984-02-17
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.02773
Reported LPN Staffing Hours per Resident per Day
0.65039
Reported RN Staffing Hours per Resident per Day
0.84922
Reported Licensed Staffing Hours per Resident per Day
1.49961
Reported Total Nurse Staffing Hours per Resident per Day
3.52734
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07930
Expected CNA Staffing Hours per Resident per Day
2.59043
Expected LPN Staffing Hours per Resident per Day
0.60004
Expected RN Staffing Hours per Resident per Day
0.93759
Expected Total Nurse Staffing Hours per Resident per Day
4.12806
Adjusted CNA Staffing Hours per Resident per Day
1.92070
Adjusted LPN Staffing Hours per Resident per Day
0.89965
Adjusted RN Staffing Hours per Resident per Day
0.67677
Adjusted Total Nurse Staffing Hours per Resident per Day
3.44432
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-02-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
23
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2014-02-14
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
14
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
82.66700
Number of Facility Reported Incidents
15
Number of Substantiated Complaints
8
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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