Golden Empire Nursing & Rehab Center - Grass Valley Nursing Home
General Information
UPDATEFederal Provider Number
56391
Provider Name
GOLDEN EMPIRE NURSING & REHAB CENTER
Provider Address
121 DORSEY DRIVE
GRASS VALLEY, CA 95945
GRASS VALLEY, CA 95945
Provider Phone Number
(530) 273-1316
Provider SSA County
390
Provider County Name
Nevada
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
148
Number of Residents in Certified Beds
139
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOLDEN EMPIRE NURSING & REHAB CENTER
Date First Approved to Provide Medicare and Medicaid services
1973-06-20
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
3.19892
Reported LPN Staffing Hours per Resident per Day
0.89928
Reported RN Staffing Hours per Resident per Day
0.51403
Reported Licensed Staffing Hours per Resident per Day
1.41331
Reported Total Nurse Staffing Hours per Resident per Day
4.61223
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14245
Expected CNA Staffing Hours per Resident per Day
2.53293
Expected LPN Staffing Hours per Resident per Day
0.63388
Expected RN Staffing Hours per Resident per Day
0.98632
Expected Total Nurse Staffing Hours per Resident per Day
4.15313
Adjusted CNA Staffing Hours per Resident per Day
3.09886
Adjusted LPN Staffing Hours per Resident per Day
1.17751
Adjusted RN Staffing Hours per Resident per Day
0.38941
Adjusted Total Nurse Staffing Hours per Resident per Day
4.47649
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-03-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-04-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
14.66700
Number of Facility Reported Incidents
1
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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