Meadowood Nursing Center - Clearlake Nursing Home
General Information
UPDATEFederal Provider Number
555490
Provider Name
MEADOWOOD NURSING CENTER
Provider Address
3805 DEXTER LANE
CLEARLAKE, CA 95422
CLEARLAKE, CA 95422
Provider Phone Number
(707) 994-7738
Provider SSA County
160
Provider County Name
Lake
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VINDRA INC
Date First Approved to Provide Medicare and Medicaid services
1992-02-20
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.37973
Reported LPN Staffing Hours per Resident per Day
0.74865
Reported RN Staffing Hours per Resident per Day
0.55203
Reported Licensed Staffing Hours per Resident per Day
1.30068
Reported Total Nurse Staffing Hours per Resident per Day
3.68041
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10068
Expected CNA Staffing Hours per Resident per Day
2.40568
Expected LPN Staffing Hours per Resident per Day
0.57537
Expected RN Staffing Hours per Resident per Day
0.84992
Expected Total Nurse Staffing Hours per Resident per Day
3.83097
Adjusted CNA Staffing Hours per Resident per Day
2.42723
Adjusted LPN Staffing Hours per Resident per Day
1.07996
Adjusted RN Staffing Hours per Resident per Day
0.48531
Adjusted Total Nurse Staffing Hours per Resident per Day
3.87248
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-03-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-02-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-11-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
41.33300
Number of Facility Reported Incidents
5
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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