Martinez Convalescent Hospital - Martinez Nursing Home
General Information
UPDATEFederal Provider Number
555821
Provider Name
MARTINEZ CONVALESCENT HOSPITAL
Provider Address
4110 ALHAMBRA WAY
MARTINEZ, CA 94553
MARTINEZ, CA 94553
Provider Phone Number
(925) 228-4260
Provider SSA County
60
Provider County Name
Contra Costa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
36
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THEKKEK HEALTH SERVICES, INC.
Date First Approved to Provide Medicare and Medicaid services
2005-03-18
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
4
Health Inspection Rating Footnote
QM Rating
5
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
2.95000
Reported LPN Staffing Hours per Resident per Day
0.43387
Reported RN Staffing Hours per Resident per Day
0.88710
Reported Licensed Staffing Hours per Resident per Day
1.32097
Reported Total Nurse Staffing Hours per Resident per Day
4.27097
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09194
Expected CNA Staffing Hours per Resident per Day
2.43791
Expected LPN Staffing Hours per Resident per Day
0.53393
Expected RN Staffing Hours per Resident per Day
0.76581
Expected Total Nurse Staffing Hours per Resident per Day
3.73765
Adjusted CNA Staffing Hours per Resident per Day
2.96911
Adjusted LPN Staffing Hours per Resident per Day
0.67446
Adjusted RN Staffing Hours per Resident per Day
0.86554
Adjusted Total Nurse Staffing Hours per Resident per Day
4.60607
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-02-05
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
2
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-02-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
37.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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