Fredericka Manor Care Center - Chula Vista Nursing Home
General Information
UPDATEFederal Provider Number
55354
Provider Name
FREDERICKA MANOR CARE CENTER
Provider Address
111 THIRD AVENUE
CHULA VISTA, CA 91910
CHULA VISTA, CA 91910
Provider Phone Number
6194272777
Provider SSA County
470
Provider County Name
San Diego
Ownership Type
Non profit - Corporation
Number of Certified Beds
174
Number of Residents in Certified Beds
166
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FRONT PORCH COMMUNITIES OPERATING GROUP LLC
Date First Approved to Provide Medicare and Medicaid services
1977-12-09
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
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
2.58404
Reported LPN Staffing Hours per Resident per Day
0.73584
Reported RN Staffing Hours per Resident per Day
1.27229
Reported Licensed Staffing Hours per Resident per Day
2.00813
Reported Total Nurse Staffing Hours per Resident per Day
4.59217
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14789
Expected CNA Staffing Hours per Resident per Day
2.41633
Expected LPN Staffing Hours per Resident per Day
0.62550
Expected RN Staffing Hours per Resident per Day
1.03589
Expected Total Nurse Staffing Hours per Resident per Day
4.07772
Adjusted CNA Staffing Hours per Resident per Day
2.62401
Adjusted LPN Staffing Hours per Resident per Day
0.97642
Adjusted RN Staffing Hours per Resident per Day
0.91772
Adjusted Total Nurse Staffing Hours per Resident per Day
4.53945
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
72
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
21
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-04-19
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
9
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-04-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
70.00000
Number of Facility Reported Incidents
8
Number of Substantiated Complaints
1
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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