Fruitvale Healthcare Center - Oakland Nursing Home
General Information
UPDATEFederal Provider Number
555358
Provider Name
FRUITVALE HEALTHCARE CENTER
Provider Address
3020 EAST 15TH STREET
OAKLAND, CA 94601
OAKLAND, CA 94601
Provider Phone Number
(510) 261-5613
Provider SSA County
0
Provider County Name
Alameda
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
140
Number of Residents in Certified Beds
138
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FRUITVALE LONG TERM CARE, LLC
Date First Approved to Provide Medicare and Medicaid services
1989-04-20
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.30072
Reported LPN Staffing Hours per Resident per Day
0.65181
Reported RN Staffing Hours per Resident per Day
1.12391
Reported Licensed Staffing Hours per Resident per Day
1.77572
Reported Total Nurse Staffing Hours per Resident per Day
4.07644
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06884
Expected CNA Staffing Hours per Resident per Day
2.31135
Expected LPN Staffing Hours per Resident per Day
0.61099
Expected RN Staffing Hours per Resident per Day
1.01134
Expected Total Nurse Staffing Hours per Resident per Day
3.93368
Adjusted CNA Staffing Hours per Resident per Day
2.44241
Adjusted LPN Staffing Hours per Resident per Day
0.88545
Adjusted RN Staffing Hours per Resident per Day
0.83037
Adjusted Total Nurse Staffing Hours per Resident per Day
4.17718
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2015-01-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
51.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
6
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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