Mountain Manor Senior Residence - Carmichael Nursing Home
General Information
UPDATEFederal Provider Number
555889
Provider Name
MOUNTAIN MANOR SENIOR RESIDENCE
Provider Address
6101 FAIR OAKS BOULEVARD
CARMICHAEL, CA 95608
CARMICHAEL, CA 95608
Provider Phone Number
(916) 488-7211
Provider SSA County
440
Provider County Name
Sacramento
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
47
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2014-09-09
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
0
Overall Rating Footnote
Too New to Rate
Health Inspection Rating
0
Health Inspection Rating Footnote
Too New to Rate
QM Rating
0
QM Rating Footnote
Too New to Rate
Staffing Rating
0
Staffing Rating Footnote
Too New to Rate
RN Staffing Rating
0
RN Staffing Rating Footnote
Too New to Rate
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.53488
Reported LPN Staffing Hours per Resident per Day
0.97907
Reported RN Staffing Hours per Resident per Day
0.40349
Reported Licensed Staffing Hours per Resident per Day
1.38256
Reported Total Nurse Staffing Hours per Resident per Day
3.91744
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01860
Expected CNA Staffing Hours per Resident per Day
0.00000
Expected LPN Staffing Hours per Resident per Day
0.00000
Expected RN Staffing Hours per Resident per Day
0.00000
Expected Total Nurse Staffing Hours per Resident per Day
0.00000
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
0000-00-00
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
0000-00-00
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
0.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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