Central Valley Specialty Hospital - Snf - Modesto Nursing Home
General Information
UPDATEFederal Provider Number
555882
Provider Name
CENTRAL VALLEY SPECIALTY HOSPITAL - SNF
Provider Address
730 17TH STREET
MODESTO, CA 95354
MODESTO, CA 95354
Provider Phone Number
(209) 248-7700
Provider SSA County
600
Provider County Name
Stanislaus
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
15
Number of Residents in Certified Beds
15
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
CENTRAL VALLEY SPECIALTY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2013-11-25
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
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
3.20000
Reported LPN Staffing Hours per Resident per Day
2.40000
Reported RN Staffing Hours per Resident per Day
1.86333
Reported Licensed Staffing Hours per Resident per Day
4.26333
Reported Total Nurse Staffing Hours per Resident per Day
7.46333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09667
Expected CNA Staffing Hours per Resident per Day
2.80842
Expected LPN Staffing Hours per Resident per Day
1.40347
Expected RN Staffing Hours per Resident per Day
1.92163
Expected Total Nurse Staffing Hours per Resident per Day
6.13352
Adjusted CNA Staffing Hours per Resident per Day
2.79582
Adjusted LPN Staffing Hours per Resident per Day
1.41934
Adjusted RN Staffing Hours per Resident per Day
0.72453
Adjusted Total Nurse Staffing Hours per Resident per Day
4.90484
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-10-31
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-11-08
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
0.00000
Number of Facility Reported Incidents
0
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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