Crestwood Manor - 112 - Modesto Nursing Home
General Information
UPDATEFederal Provider Number
05A024
Provider Name
CRESTWOOD MANOR - 112
Provider Address
1400 CELESTE DR.
MODESTO, CA 95355
MODESTO, CA 95355
Provider Phone Number
2095268050
Provider SSA County
600
Provider County Name
Stanislaus
Ownership Type
For profit - Corporation
Number of Certified Beds
194
Number of Residents in Certified Beds
174
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1979-06-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.22701
Reported LPN Staffing Hours per Resident per Day
0.92845
Reported RN Staffing Hours per Resident per Day
0.14425
Reported Licensed Staffing Hours per Resident per Day
1.07270
Reported Total Nurse Staffing Hours per Resident per Day
3.29971
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00259
Expected CNA Staffing Hours per Resident per Day
1.73857
Expected LPN Staffing Hours per Resident per Day
0.54424
Expected RN Staffing Hours per Resident per Day
0.71410
Expected Total Nurse Staffing Hours per Resident per Day
2.99691
Adjusted CNA Staffing Hours per Resident per Day
3.14306
Adjusted LPN Staffing Hours per Resident per Day
1.41594
Adjusted RN Staffing Hours per Resident per Day
0.15094
Adjusted Total Nurse Staffing Hours per Resident per Day
4.43818
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-06-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-06-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
40
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
31.33300
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
Nursiong Homes Nearby
Hy-lond Health Care Center - Modesto
1900 Coffee Road |
MODESTO CA 95355 | 0.2 mile away
Casa De Modesto
1745 Eldena Way |
MODESTO CA 95350 | 0.9 mile away
Avalon Care Center - Modesto
515 East Orangeburg Avenue |
MODESTO CA 95350 | 0.9 mile away
Modesto Post Acute Center
159 E. Orangeburg Avenue |
MODESTO CA 95350 | 1.2 miles away
Acacia Park Nursing & Rehab Center
1611 Scenic Drive |
MODESTO CA 95355 | 1.4 miles away
Central Valley Specialty Hospital - Snf
730 17th Street |
MODESTO CA 95354 | 2.2 miles away
Garden City Healthcare Center
1310 West Granger |
MODESTO CA 95350 | 2.3 miles away
Evergreen Nursing & Rehabilitation Care Center
2030 Evergreen Avenue |
MODESTO CA 95350 | 3.1 miles away
English Oaks Conv & Rehab Hospital
2633 West Rumble Rd |
MODESTO CA 95350 | 4 miles away
Vintage Faire Nursing & Rehab
3620 B Dale Rd. |
MODESTO CA 95356 | 4.4 miles away
Ha-le Aloha Convalescent Hospital
1711 Richland Avenue |
CERES CA 95307 | 4.7 miles away
Riverbank Nursing Center
2649 West Topeka Avenue |
RIVERBANK CA 95367 | 4.7 miles away
Oak Valley Care Center D/p Snf
275 South Oak Avenue |
OAKDALE CA 95361 | 8.6 miles away
Turlock Nursing & Rehabilitation Center
1111 E Tuolumne Road |
TURLOCK CA 95380 | 13.1 miles away
Covenant Village Care Center
2125 North Olive Avenue |
TURLOCK CA 95382 | 13.1 miles away
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