Crystal Cove Care Center - Newport Beach Nursing Home
General Information
UPDATEFederal Provider Number
55929
Provider Name
CRYSTAL COVE CARE CENTER
Provider Address
1445 SUPERIOR AVENUE
NEWPORT BEACH, CA 92663
NEWPORT BEACH, CA 92663
Provider Phone Number
(949) 515-3930
Provider SSA County
400
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
96
Number of Residents in Certified Beds
82
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORWAY MAPLE HOLDINGS, LLC
Date First Approved to Provide Medicare and Medicaid services
1973-01-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
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
2.38232
Reported LPN Staffing Hours per Resident per Day
1.12500
Reported RN Staffing Hours per Resident per Day
0.95305
Reported Licensed Staffing Hours per Resident per Day
2.07805
Reported Total Nurse Staffing Hours per Resident per Day
4.46037
Reported Physical Therapist Staffing Hours per Resident Per Day
0.31585
Expected CNA Staffing Hours per Resident per Day
2.69854
Expected LPN Staffing Hours per Resident per Day
0.84422
Expected RN Staffing Hours per Resident per Day
1.53286
Expected Total Nurse Staffing Hours per Resident per Day
5.07562
Adjusted CNA Staffing Hours per Resident per Day
2.16617
Adjusted LPN Staffing Hours per Resident per Day
1.10605
Adjusted RN Staffing Hours per Resident per Day
0.46457
Adjusted Total Nurse Staffing Hours per Resident per Day
3.54229
Cycle 1 Total Number of Health Deficiencies
20
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-05-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
27
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
120
Cycle 2 Standard Health Survey Date
2013-05-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
120
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-06-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
97.33300
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
7
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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