Crystal Ridge Care Center - Grass Valley Nursing Home
General Information
UPDATEFederal Provider Number
555283
Provider Name
CRYSTAL RIDGE CARE CENTER
Provider Address
396 DORSEY DRIVE
GRASS VALLEY, CA 95945
GRASS VALLEY, CA 95945
Provider Phone Number
(530) 272-2273
Provider SSA County
390
Provider County Name
Nevada
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EDELWEISS HOLDINGS, LLC
Date First Approved to Provide Medicare and Medicaid services
1987-09-28
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.51131
Reported LPN Staffing Hours per Resident per Day
1.02440
Reported RN Staffing Hours per Resident per Day
0.58214
Reported Licensed Staffing Hours per Resident per Day
1.60655
Reported Total Nurse Staffing Hours per Resident per Day
4.11785
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14702
Expected CNA Staffing Hours per Resident per Day
2.30288
Expected LPN Staffing Hours per Resident per Day
0.62576
Expected RN Staffing Hours per Resident per Day
1.00836
Expected Total Nurse Staffing Hours per Resident per Day
3.93700
Adjusted CNA Staffing Hours per Resident per Day
2.67578
Adjusted LPN Staffing Hours per Resident per Day
1.35874
Adjusted RN Staffing Hours per Resident per Day
0.43137
Adjusted Total Nurse Staffing Hours per Resident per Day
4.21606
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-09-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
8
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-08-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
12
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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