Dept Of State Hospitals - Napa D/p Snf - Napa Nursing Home
General Information
UPDATEFederal Provider Number
05A357
Provider Name
DEPT OF STATE HOSPITALS - NAPA D/P SNF
Provider Address
2100 NAPA-VALLEJO HIGHWAY
NAPA, CA 94558
NAPA, CA 94558
Provider Phone Number
(707) 253-5000
Provider SSA County
380
Provider County Name
Napa
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
36
Number of Residents in Certified Beds
28
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1984-06-14
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
2.85714
Reported LPN Staffing Hours per Resident per Day
0.20357
Reported RN Staffing Hours per Resident per Day
4.79643
Reported Licensed Staffing Hours per Resident per Day
5.00000
Reported Total Nurse Staffing Hours per Resident per Day
7.85714
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.50289
Expected LPN Staffing Hours per Resident per Day
0.68291
Expected RN Staffing Hours per Resident per Day
0.90401
Expected Total Nurse Staffing Hours per Resident per Day
4.08982
Adjusted CNA Staffing Hours per Resident per Day
2.80098
Adjusted LPN Staffing Hours per Resident per Day
0.24742
Adjusted RN Staffing Hours per Resident per Day
3.96443
Adjusted Total Nurse Staffing Hours per Resident per Day
7.74395
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
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
20
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
17
Cycle 2 Health Deficiency Score
148
Cycle 2 Standard Health Survey Date
2014-03-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
148
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
52
Cycle 3 Standard Health Survey Date
2013-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
68.00000
Number of Facility Reported Incidents
3
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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