Espanola Valley Nursing And Rehab - Espanola Nursing Home
General Information
UPDATEFederal Provider Number
325059
Provider Name
ESPANOLA VALLEY NURSING AND REHAB
Provider Address
720 HACIENDA STREET
ESPANOLA, NM 87532
ESPANOLA, NM 87532
Provider Phone Number
5057536769
Provider SSA County
190
Provider County Name
Rio Arriba
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ESPANOLA HEALTH FACILITIES, LP
Date First Approved to Provide Medicare and Medicaid services
1992-02-01
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
2
QM Rating Footnote
Staffing Rating
2
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
0.42405
Reported LPN Staffing Hours per Resident per Day
0.78544
Reported RN Staffing Hours per Resident per Day
0.57025
Reported Licensed Staffing Hours per Resident per Day
1.35570
Reported Total Nurse Staffing Hours per Resident per Day
1.77974
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07785
Expected CNA Staffing Hours per Resident per Day
2.61838
Expected LPN Staffing Hours per Resident per Day
0.63742
Expected RN Staffing Hours per Resident per Day
0.97128
Expected Total Nurse Staffing Hours per Resident per Day
4.22708
Adjusted CNA Staffing Hours per Resident per Day
0.39738
Adjusted LPN Staffing Hours per Resident per Day
1.02274
Adjusted RN Staffing Hours per Resident per Day
0.43869
Adjusted Total Nurse Staffing Hours per Resident per Day
1.69714
Cycle 1 Total Number of Health Deficiencies
20
Cycle 1 Number of Standard Health Deficiencies
20
Cycle 1 Number of Complaint Health Deficiencies
20
Cycle 1 Health Deficiency Score
635
Cycle 1 Standard Survey Health Date
2014-07-29
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
318
Cycle 1 Total Health Score
953
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
18
Cycle 2 Health Deficiency Score
196
Cycle 2 Standard Health Survey Date
2013-09-16
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
23
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
16
Cycle 3 Health Deficiency Score
350
Cycle 3 Standard Health Survey Date
2012-08-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
350
Total Weighted Health Survey Score
600.16700
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
19
Number of Fines
2
Total Amount of Fines in Dollars
19408
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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