Manorcare Health Services - Tice Valley - Walnut Creek Nursing Home
General Information
UPDATEFederal Provider Number
555710
Provider Name
MANORCARE HEALTH SERVICES - TICE VALLEY
Provider Address
1975 TICE VALLEY BLVD.
WALNUT CREEK, CA 94595
WALNUT CREEK, CA 94595
Provider Phone Number
(925) 906-0200
Provider SSA County
60
Provider County Name
Contra Costa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE-TICE VALLEY CA LLC
Date First Approved to Provide Medicare and Medicaid services
1997-08-07
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
2.42710
Reported LPN Staffing Hours per Resident per Day
0.49299
Reported RN Staffing Hours per Resident per Day
1.89766
Reported Licensed Staffing Hours per Resident per Day
2.39065
Reported Total Nurse Staffing Hours per Resident per Day
4.81775
Reported Physical Therapist Staffing Hours per Resident Per Day
0.35561
Expected CNA Staffing Hours per Resident per Day
2.60010
Expected LPN Staffing Hours per Resident per Day
0.73639
Expected RN Staffing Hours per Resident per Day
1.41931
Expected Total Nurse Staffing Hours per Resident per Day
4.75580
Adjusted CNA Staffing Hours per Resident per Day
2.29044
Adjusted LPN Staffing Hours per Resident per Day
0.55566
Adjusted RN Staffing Hours per Resident per Day
0.99903
Adjusted Total Nurse Staffing Hours per Resident per Day
4.08341
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-04-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-02-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2011-11-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
48.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
7
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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