Braswell's Yucaipa Valley Conv - Yucaipa Nursing Home
General Information
UPDATEFederal Provider Number
55557
Provider Name
BRASWELL'S YUCAIPA VALLEY CONV
Provider Address
35253 AVENUE H
YUCAIPA, CA 92399
YUCAIPA, CA 92399
Provider Phone Number
(909) 795-2476
Provider SSA County
460
Provider County Name
San Bernardino
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
59
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BRASWELLS YUCAIPA VALLEY CONVALESCENT LP
Date First Approved to Provide Medicare and Medicaid services
1976-08-01
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
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
2.54909
Reported LPN Staffing Hours per Resident per Day
0.98182
Reported RN Staffing Hours per Resident per Day
0.37636
Reported Licensed Staffing Hours per Resident per Day
1.35818
Reported Total Nurse Staffing Hours per Resident per Day
3.90727
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11909
Expected CNA Staffing Hours per Resident per Day
2.18827
Expected LPN Staffing Hours per Resident per Day
0.60848
Expected RN Staffing Hours per Resident per Day
1.01460
Expected Total Nurse Staffing Hours per Resident per Day
3.81136
Adjusted CNA Staffing Hours per Resident per Day
2.85828
Adjusted LPN Staffing Hours per Resident per Day
1.33925
Adjusted RN Staffing Hours per Resident per Day
0.27717
Adjusted Total Nurse Staffing Hours per Resident per Day
4.13233
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-08-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
190
Cycle 2 Standard Health Survey Date
2013-11-07
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
190
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
2012-11-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
110.66700
Number of Facility Reported Incidents
4
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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