Fountain Care Center - Orange Nursing Home
General Information
UPDATEFederal Provider Number
555259
Provider Name
FOUNTAIN CARE CENTER
Provider Address
1835 WEST LA VETA AVENUE
ORANGE, CA 92868
ORANGE, CA 92868
Provider Phone Number
(714) 978-6800
Provider SSA County
400
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
169
Number of Residents in Certified Beds
141
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOUNTAIN CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1987-03-04
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
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.28582
Reported LPN Staffing Hours per Resident per Day
0.66418
Reported RN Staffing Hours per Resident per Day
0.84291
Reported Licensed Staffing Hours per Resident per Day
1.50709
Reported Total Nurse Staffing Hours per Resident per Day
3.79291
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09220
Expected CNA Staffing Hours per Resident per Day
2.48933
Expected LPN Staffing Hours per Resident per Day
0.69073
Expected RN Staffing Hours per Resident per Day
1.17938
Expected Total Nurse Staffing Hours per Resident per Day
4.35945
Adjusted CNA Staffing Hours per Resident per Day
2.25310
Adjusted LPN Staffing Hours per Resident per Day
0.79809
Adjusted RN Staffing Hours per Resident per Day
0.53403
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50706
Cycle 1 Total Number of Health Deficiencies
24
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
10
Cycle 1 Health Deficiency Score
104
Cycle 1 Standard Survey Health Date
2014-05-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
104
Cycle 2 Total Number of Health Deficiencies
30
Cycle 2 Number of Standard Health Deficiencies
24
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
140
Cycle 2 Standard Health Survey Date
2013-04-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
140
Cycle 3 Total Number of Health Deficiencies
38
Cycle 3 Number of Standard Health Deficiencies
28
Cycle 3 Number of Complaint Health Deficiencies
10
Cycle 3 Health Deficiency Score
188
Cycle 3 Standard Health Survey Date
2012-05-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
188
Total Weighted Health Survey Score
130.00000
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
17
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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