Eastern Plumas Hospital- Portola Campus Dp/snf - Portola Nursing Home
General Information
UPDATEFederal Provider Number
555433
Provider Name
EASTERN PLUMAS HOSPITAL- PORTOLA CAMPUS DP/SNF
Provider Address
500 FIRST STREET
PORTOLA, CA 96122
PORTOLA, CA 96122
Provider Phone Number
(530) 832-4277
Provider SSA County
420
Provider County Name
Plumas
Provider Website
Provider Description
Ownership Type
Government - Hospital district
Number of Certified Beds
66
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
EASTERN PLUMAS HEALTH CARE DISTRICT
Date First Approved to Provide Medicare and Medicaid services
1990-09-11
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.92396
Reported LPN Staffing Hours per Resident per Day
0.88646
Reported RN Staffing Hours per Resident per Day
0.63229
Reported Licensed Staffing Hours per Resident per Day
1.51875
Reported Total Nurse Staffing Hours per Resident per Day
4.44271
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12083
Expected CNA Staffing Hours per Resident per Day
2.32764
Expected LPN Staffing Hours per Resident per Day
0.63017
Expected RN Staffing Hours per Resident per Day
0.89932
Expected Total Nurse Staffing Hours per Resident per Day
3.85712
Adjusted CNA Staffing Hours per Resident per Day
3.08232
Adjusted LPN Staffing Hours per Resident per Day
1.16757
Adjusted RN Staffing Hours per Resident per Day
0.52534
Adjusted Total Nurse Staffing Hours per Resident per Day
4.64287
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-06-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
31
Cycle 2 Number of Standard Health Deficiencies
29
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
268
Cycle 2 Standard Health Survey Date
2013-06-28
Cycle 2 Number of Health Revisits
4
Cycle 2 Health Revisit Score
228
Cycle 2 Total Health Score
496
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
28
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
198.00000
Number of Facility Reported Incidents
8
Number of Substantiated Complaints
2
Number of Fines
2
Total Amount of Fines in Dollars
5200
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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