Plymouth Village - Redlands Nursing Home
General Information
UPDATEFederal Provider Number
55914
Provider Name
PLYMOUTH VILLAGE
Provider Address
819 SALEM DRIVE
REDLANDS, CA 92373
REDLANDS, CA 92373
Provider Phone Number
(909) 793-1233
Provider SSA County
460
Provider County Name
San Bernardino
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICAN BAPTIST HOMES OF THE WEST
Date First Approved to Provide Medicare and Medicaid services
1968-03-29
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.34773
Reported LPN Staffing Hours per Resident per Day
0.80568
Reported RN Staffing Hours per Resident per Day
0.89205
Reported Licensed Staffing Hours per Resident per Day
1.69773
Reported Total Nurse Staffing Hours per Resident per Day
4.04546
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12955
Expected CNA Staffing Hours per Resident per Day
2.61502
Expected LPN Staffing Hours per Resident per Day
0.57706
Expected RN Staffing Hours per Resident per Day
0.98413
Expected Total Nurse Staffing Hours per Resident per Day
4.17621
Adjusted CNA Staffing Hours per Resident per Day
2.20290
Adjusted LPN Staffing Hours per Resident per Day
1.15884
Adjusted RN Staffing Hours per Resident per Day
0.67729
Adjusted Total Nurse Staffing Hours per Resident per Day
3.90470
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-11-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2014-01-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2013-02-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
51.33300
Number of Facility Reported Incidents
4
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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