Mesa Verde Post Acute Care Center - Costa Mesa Nursing Home
General Information
UPDATEFederal Provider Number
56362
Provider Name
MESA VERDE POST ACUTE CARE CENTER
Provider Address
661 CENTER STREET
COSTA MESA, CA 92627
COSTA MESA, CA 92627
Provider Phone Number
(949) 548-5584
Provider SSA County
400
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MESA VERDE CONVALESCENT HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1972-09-01
Continuing Care Retirement Community
Y
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
2.24638
Reported LPN Staffing Hours per Resident per Day
0.77174
Reported RN Staffing Hours per Resident per Day
0.68696
Reported Licensed Staffing Hours per Resident per Day
1.45870
Reported Total Nurse Staffing Hours per Resident per Day
3.70508
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15217
Expected CNA Staffing Hours per Resident per Day
2.59249
Expected LPN Staffing Hours per Resident per Day
0.73180
Expected RN Staffing Hours per Resident per Day
1.24635
Expected Total Nurse Staffing Hours per Resident per Day
4.57064
Adjusted CNA Staffing Hours per Resident per Day
2.12612
Adjusted LPN Staffing Hours per Resident per Day
0.87529
Adjusted RN Staffing Hours per Resident per Day
0.41184
Adjusted Total Nurse Staffing Hours per Resident per Day
3.26755
Cycle 1 Total Number of Health Deficiencies
23
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
12
Cycle 1 Health Deficiency Score
104
Cycle 1 Standard Survey Health Date
2015-04-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
104
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2014-03-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
24
Cycle 3 Number of Standard Health Deficiencies
24
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
124
Cycle 3 Standard Health Survey Date
2013-02-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
124
Total Weighted Health Survey Score
95.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
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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