Crescent Court Nursing Home - Lodi Nursing Home
General Information
UPDATEFederal Provider Number
555079
Provider Name
CRESCENT COURT NURSING HOME
Provider Address
610 S FAIRMONT AVENUE
LODI, CA 95240
LODI, CA 95240
Provider Phone Number
(209) 367-7400
Provider SSA County
490
Provider County Name
San Joaquin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
28
Number of Residents in Certified Beds
21
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BECHTHOLD CONVALESCENT HOSPITAL, INC
Date First Approved to Provide Medicare and Medicaid services
1978-01-01
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
3
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
2.76190
Reported LPN Staffing Hours per Resident per Day
1.54762
Reported RN Staffing Hours per Resident per Day
1.04762
Reported Licensed Staffing Hours per Resident per Day
2.59524
Reported Total Nurse Staffing Hours per Resident per Day
5.35714
Reported Physical Therapist Staffing Hours per Resident Per Day
0.24524
Expected CNA Staffing Hours per Resident per Day
2.38204
Expected LPN Staffing Hours per Resident per Day
0.57501
Expected RN Staffing Hours per Resident per Day
0.83826
Expected Total Nurse Staffing Hours per Resident per Day
3.79531
Adjusted CNA Staffing Hours per Resident per Day
2.84499
Adjusted LPN Staffing Hours per Resident per Day
2.23393
Adjusted RN Staffing Hours per Resident per Day
0.93382
Adjusted Total Nurse Staffing Hours per Resident per Day
5.68969
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-05-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-05-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-04-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
50.00000
Number of Facility Reported Incidents
2
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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