Community Care On Palm - Riverside Nursing Home
General Information
UPDATEFederal Provider Number
555711
Provider Name
COMMUNITY CARE ON PALM
Provider Address
4768 PALM AVENUE
RIVERSIDE, CA 92501
RIVERSIDE, CA 92501
Provider Phone Number
(951) 686-9001
Provider SSA County
430
Provider County Name
Riverside
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
51
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOUTH COAST HEALTH & WELLNESS CORP
Date First Approved to Provide Medicare and Medicaid services
1997-09-06
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
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.75408
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.39490
Reported Licensed Staffing Hours per Resident per Day
0.39490
Reported Total Nurse Staffing Hours per Resident per Day
4.14898
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08163
Expected CNA Staffing Hours per Resident per Day
2.39849
Expected LPN Staffing Hours per Resident per Day
0.56187
Expected RN Staffing Hours per Resident per Day
0.80271
Expected Total Nurse Staffing Hours per Resident per Day
3.76307
Adjusted CNA Staffing Hours per Resident per Day
3.84049
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.36759
Adjusted Total Nurse Staffing Hours per Resident per Day
4.44427
Cycle 1 Total Number of Health Deficiencies
21
Cycle 1 Number of Standard Health Deficiencies
20
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
108
Cycle 1 Standard Survey Health Date
2015-03-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-03-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-03-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
66.00000
Number of Facility Reported Incidents
5
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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