La Mariposa Care And Rehab Center - Fairfield Nursing Home
General Information
UPDATEFederal Provider Number
56086
Provider Name
LA MARIPOSA CARE AND REHAB CENTER
Provider Address
1244 TRAVIS BLVD
FAIRFIELD, CA 94533
FAIRFIELD, CA 94533
Provider Phone Number
(707) 422-7750
Provider SSA County
580
Provider County Name
Solano
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
90
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SAGAR, INC.
Date First Approved to Provide Medicare and Medicaid services
1969-08-11
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
4.76167
Reported LPN Staffing Hours per Resident per Day
0.95278
Reported RN Staffing Hours per Resident per Day
0.85222
Reported Licensed Staffing Hours per Resident per Day
1.80500
Reported Total Nurse Staffing Hours per Resident per Day
6.56667
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09778
Expected CNA Staffing Hours per Resident per Day
2.41575
Expected LPN Staffing Hours per Resident per Day
0.56279
Expected RN Staffing Hours per Resident per Day
0.88111
Expected Total Nurse Staffing Hours per Resident per Day
3.85965
Adjusted CNA Staffing Hours per Resident per Day
4.83648
Adjusted LPN Staffing Hours per Resident per Day
1.40516
Adjusted RN Staffing Hours per Resident per Day
0.72270
Adjusted Total Nurse Staffing Hours per Resident per Day
6.85803
Cycle 1 Total Number of Health Deficiencies
26
Cycle 1 Number of Standard Health Deficiencies
22
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
180
Cycle 1 Standard Survey Health Date
2014-10-13
Cycle 1 Number of Health Revisits
3
Cycle 1 Health Revisit Score
126
Cycle 1 Total Health Score
306
Cycle 2 Total Number of Health Deficiencies
25
Cycle 2 Number of Standard Health Deficiencies
19
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
184
Cycle 2 Standard Health Survey Date
2013-10-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
184
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
219.00000
Number of Facility Reported Incidents
14
Number of Substantiated Complaints
21
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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