Cherry Valley Healthcare - Banning Nursing Home
General Information
UPDATEFederal Provider Number
555309
Provider Name
CHERRY VALLEY HEALTHCARE
Provider Address
5800 WEST WILSON STREET
BANNING, CA 92220
BANNING, CA 92220
Provider Phone Number
(951) 845-1606
Provider SSA County
430
Provider County Name
Riverside
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
132
Number of Residents in Certified Beds
112
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLOVERLEAF ENTERPRISES, INC.
Date First Approved to Provide Medicare and Medicaid services
1988-04-27
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
3
QM Rating Footnote
Staffing Rating
4
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
2.63482
Reported LPN Staffing Hours per Resident per Day
0.97946
Reported RN Staffing Hours per Resident per Day
0.77143
Reported Licensed Staffing Hours per Resident per Day
1.75089
Reported Total Nurse Staffing Hours per Resident per Day
4.38571
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10268
Expected CNA Staffing Hours per Resident per Day
2.38074
Expected LPN Staffing Hours per Resident per Day
0.64997
Expected RN Staffing Hours per Resident per Day
1.03741
Expected Total Nurse Staffing Hours per Resident per Day
4.06813
Adjusted CNA Staffing Hours per Resident per Day
2.71557
Adjusted LPN Staffing Hours per Resident per Day
1.25075
Adjusted RN Staffing Hours per Resident per Day
0.55563
Adjusted Total Nurse Staffing Hours per Resident per Day
4.34558
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-12-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
66.00000
Number of Facility Reported Incidents
3
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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