Cottonwood Canyon Healthcare Center - El Cajon Nursing Home
General Information
UPDATEFederal Provider Number
55064
Provider Name
COTTONWOOD CANYON HEALTHCARE CENTER
Provider Address
1391 MADISON AVENUE
EL CAJON, CA 92021
EL CAJON, CA 92021
Provider Phone Number
(619) 444-1107
Provider SSA County
470
Provider County Name
San Diego
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
96
Number of Residents in Certified Beds
90
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KOA HOLDINGS LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.44056
Reported LPN Staffing Hours per Resident per Day
0.80222
Reported RN Staffing Hours per Resident per Day
0.66778
Reported Licensed Staffing Hours per Resident per Day
1.47000
Reported Total Nurse Staffing Hours per Resident per Day
3.91056
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18611
Expected CNA Staffing Hours per Resident per Day
2.55284
Expected LPN Staffing Hours per Resident per Day
0.68767
Expected RN Staffing Hours per Resident per Day
1.13006
Expected Total Nurse Staffing Hours per Resident per Day
4.37058
Adjusted CNA Staffing Hours per Resident per Day
2.34578
Adjusted LPN Staffing Hours per Resident per Day
0.96825
Adjusted RN Staffing Hours per Resident per Day
0.44154
Adjusted Total Nurse Staffing Hours per Resident per Day
3.60663
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-02-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-02-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
3
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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