Kindred Transitional Care & Rehab - Valley Gardens - Stockton Nursing Home
General Information
UPDATEFederal Provider Number
555307
Provider Name
KINDRED TRANSITIONAL CARE & REHAB - VALLEY GARDENS
Provider Address
1517 EAST KNICKERBOCKER DRIVE
STOCKTON, CA 95210
STOCKTON, CA 95210
Provider Phone Number
(209) 957-4539
Provider SSA County
490
Provider County Name
San Joaquin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KINDRED NURSING CENTERS WEST LLC
Date First Approved to Provide Medicare and Medicaid services
1988-05-02
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.21186
Reported LPN Staffing Hours per Resident per Day
1.05670
Reported RN Staffing Hours per Resident per Day
0.94278
Reported Licensed Staffing Hours per Resident per Day
1.99948
Reported Total Nurse Staffing Hours per Resident per Day
4.21134
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14948
Expected CNA Staffing Hours per Resident per Day
2.47722
Expected LPN Staffing Hours per Resident per Day
0.69599
Expected RN Staffing Hours per Resident per Day
1.26701
Expected Total Nurse Staffing Hours per Resident per Day
4.44021
Adjusted CNA Staffing Hours per Resident per Day
2.19086
Adjusted LPN Staffing Hours per Resident per Day
1.26017
Adjusted RN Staffing Hours per Resident per Day
0.55599
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82313
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
10
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
27
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
17
Cycle 2 Health Deficiency Score
100
Cycle 2 Standard Health Survey Date
2013-05-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
100
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-07-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
80.00000
Number of Facility Reported Incidents
15
Number of Substantiated Complaints
27
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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